Trends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database study

Abstract Purpose To examine racial and ethnic disparities in Health-Related Quality of Life (HRQOL) in older adults with breast cancer, both pre- and post-diagnosis. Methods Using the SEER-MHOS database, we included patients ≥ 65 years old with breast cancer who completed the Health Outcomes Survey...

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Main Authors: Nicki Karimi-Mostowfi, Fang-I Chu, Trudy C. Wu, Matthew J. Farrell, Wisdom Akingbemi, Ann C. Raldow
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Health and Quality of Life Outcomes
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Online Access:https://doi.org/10.1186/s12955-025-02359-x
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author Nicki Karimi-Mostowfi
Fang-I Chu
Trudy C. Wu
Matthew J. Farrell
Wisdom Akingbemi
Ann C. Raldow
author_facet Nicki Karimi-Mostowfi
Fang-I Chu
Trudy C. Wu
Matthew J. Farrell
Wisdom Akingbemi
Ann C. Raldow
author_sort Nicki Karimi-Mostowfi
collection DOAJ
description Abstract Purpose To examine racial and ethnic disparities in Health-Related Quality of Life (HRQOL) in older adults with breast cancer, both pre- and post-diagnosis. Methods Using the SEER-MHOS database, we included patients ≥ 65 years old with breast cancer who completed the Health Outcomes Survey within 24 months pre- and post-diagnosis, and who were non-Hispanic White, non-Hispanic Asian or Pacific Islander, non-Hispanic Black or African American, or Hispanic. HRQOL data was measured via the Physical and Mental Component Summary (PCS, MCS). Univariable and multivariable linear regression models were fitted to assess for potential disparities between races and ethnicities. Results On univariable regression models, a numerical drop in mean scores of PCS and MCS was found among all racial/ethnic groups between pre- and post-diagnosis. Among patients in the pre-diagnosis cohort who would be diagnosed with stage IV breast cancer, race was found to be a predictor of PCS with overall significance (p = 0.04). On the local test, compared with Black individuals, White individuals had higher pre-diagnosis PCS scores (+ 13.32, p = 0.03). Race/ethnicity was not found to be a predictor in PCS or MCS scores otherwise. Conclusion Among older patients diagnosed with stage IV breast cancer, White individuals had better physical HRQOL than Black patients’ pre-diagnosis. The decrease in the numerical HRQOL scores of the physical domain in all groups post-diagnosis highlights the potential negative physical impact of breast cancer has on patients, demonstrating the need for determining the proper resources and support to improve physical HRQOL following diagnosis.
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spelling doaj-art-7fc7cba97d504209900e4ebfc0cdb0ab2025-08-20T02:49:16ZengBMCHealth and Quality of Life Outcomes1477-75252025-03-012311910.1186/s12955-025-02359-xTrends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database studyNicki Karimi-Mostowfi0Fang-I Chu1Trudy C. Wu2Matthew J. Farrell3Wisdom Akingbemi4Ann C. Raldow5Lewis Katz School of Medicine, Temple UniversityUCLA Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Westwood Radiation OncologyUCLA Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Westwood Radiation OncologyUCLA Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Westwood Radiation OncologyDrexel University College of MedicineUCLA Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Westwood Radiation OncologyAbstract Purpose To examine racial and ethnic disparities in Health-Related Quality of Life (HRQOL) in older adults with breast cancer, both pre- and post-diagnosis. Methods Using the SEER-MHOS database, we included patients ≥ 65 years old with breast cancer who completed the Health Outcomes Survey within 24 months pre- and post-diagnosis, and who were non-Hispanic White, non-Hispanic Asian or Pacific Islander, non-Hispanic Black or African American, or Hispanic. HRQOL data was measured via the Physical and Mental Component Summary (PCS, MCS). Univariable and multivariable linear regression models were fitted to assess for potential disparities between races and ethnicities. Results On univariable regression models, a numerical drop in mean scores of PCS and MCS was found among all racial/ethnic groups between pre- and post-diagnosis. Among patients in the pre-diagnosis cohort who would be diagnosed with stage IV breast cancer, race was found to be a predictor of PCS with overall significance (p = 0.04). On the local test, compared with Black individuals, White individuals had higher pre-diagnosis PCS scores (+ 13.32, p = 0.03). Race/ethnicity was not found to be a predictor in PCS or MCS scores otherwise. Conclusion Among older patients diagnosed with stage IV breast cancer, White individuals had better physical HRQOL than Black patients’ pre-diagnosis. The decrease in the numerical HRQOL scores of the physical domain in all groups post-diagnosis highlights the potential negative physical impact of breast cancer has on patients, demonstrating the need for determining the proper resources and support to improve physical HRQOL following diagnosis.https://doi.org/10.1186/s12955-025-02359-xBreast cancerHRQOLRacial disparitiesEthnic disparitiesQuality of life
spellingShingle Nicki Karimi-Mostowfi
Fang-I Chu
Trudy C. Wu
Matthew J. Farrell
Wisdom Akingbemi
Ann C. Raldow
Trends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database study
Health and Quality of Life Outcomes
Breast cancer
HRQOL
Racial disparities
Ethnic disparities
Quality of life
title Trends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database study
title_full Trends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database study
title_fullStr Trends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database study
title_full_unstemmed Trends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database study
title_short Trends in racial and ethnic disparities in the health-related quality of life of older adults with breast cancer: a SEER-MHOS national database study
title_sort trends in racial and ethnic disparities in the health related quality of life of older adults with breast cancer a seer mhos national database study
topic Breast cancer
HRQOL
Racial disparities
Ethnic disparities
Quality of life
url https://doi.org/10.1186/s12955-025-02359-x
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