This 3-year special project proposes to examine racial/ethnic variations in and associations between disease-specific symptoms, quality of life (QOL), and site of death during the terminal stages of lung cancer for newly diagnosed lung cancer cases enrolled by the Deep South CanCORS Consortium. Working closely with the Consortium, the special study will identify advanced lung cancer subjects (with tumor(s) inoperable for staging reasons), and follow them bimonthly by telephone until the subject's death or the end of the special study. Bimonthly follow-up is to include administration of at least two disease-specific instruments: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer Specific Module (EORTC QLQ-LC13), which measures symptoms; and the Functional Assessment of Cancer Therapy lung cancer module(FACT-L), which assesses QOL. At least one general instrument is also proposed for use, SF-36, with physical functioning and role limitation subscales. Following the subject's death, staff will telephone and interview the nearest relative about the death using an investigator-developed, nine-item survey. Utilizing descriptive statistics and multi-variable models, investigators will test whether: African-Americans have lower QOL and worse symptom control than Caucasians; subjects with better symptom control have higher QOL; and subjects with higher QOL or better symptom control are more likely to die at home.
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