Journal
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
Volume 30, Issue 7, Pages 1366-1374Publisher
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-20-1823
Keywords
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Funding
- NCI of the NIH [T32 CA094061-18, T32 CA094880, K05 CA152715, R01 CA196337]
- National Institute of Environmental Health Sciences (NIEHS) of the NIH [T32 ES0115459]
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The study found that lower income colorectal cancer survivors are likely to report lower health-related quality of life (HRQoL) after diagnosis, with slightly greater impacts in lower socioeconomic status (SES) neighborhoods.
Background: Existing evidence indicates household income as a predictor of health-related quality of life (HRQoL) following a colorectal cancer diagnosis. This association likely varies with neighborhood socioeconomic status (nSES), but evidence is limited. Methods: We included data from 1,355 colorectal cancer survivors participating in the population-based Puget Sound Colorectal Cancer Cohort (PSCCC). Survivors reported current annual household income; we measured HRQoL via the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) tool. Using neighborhood data summarized within a 1-km radial buffer of Census block group centroids, we constructed a multidimensional nSES index measure. We employed survivors' geocoded residential addresses to append nSES score for Census block group of residence. With linear generalized estimating equations clustered on survivor location, we evaluated associations of household income with differences in FACT-C mean score, overall and stratified by nSES. We used separate models to explore relationships for wellbeing subscales. Results: We found lower household income to be associated with clinically meaningful differences in overall FACT-C scores [<$30K: -13.6; 95% confidence interval (CI): -16.8 to -10.4] and subscale wellbeing after a recent colorectal cancer diagnosis. Relationships were slightly greater in magnitude for survivors living in lower SES neighborhoods. Conclusions: Our findings suggest that recently diagnosed lower income colorectal cancer survivors are likely to report lower HRQoL, and modestly more so in lower SES neighborhoods. Impact: The findings from this work will aid future investigators' ability to further consider the contexts in which the income of survivors can be leveraged as a means of improving HRQoL
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