Despite known physical and functional problems associated with breast cancer, little is known about whether differences exist for minorities, the poor and medically underserved - groups that are largely excluded the overwhelming bulk of cancer survivorship studies. We have the extraordinary opportunity to partner with the Southern Community Cohort Study (SCCS) to explore physical and functional limitations and well being for breast cancer survivors already enrolled in the SCCS. As of Nov. 1, 2008 there are 644 African American and 490 non-Hispanic white breast cancer survivors (for a total of 1,134) in the SCCS. Over half report household incomes of $15K/year or lower. Further, more than half have survived breast cancer at least 7 years with little variation between AAs and non-Hispanic whites.
Our specific aims are:
Aim 1 : Measure breast cancer specific physical and functional limitations and symptoms among AAs, poor and medically underserved BCS. H1.1: AAs have significantly higher prevalences of breast cancer specific physical and functional limitations and symptoms (shoulder range of motion &strength, ability to accomplish functional tasks, lymphedema, pain, fatigue) than non-minorities. H1.2: Those with low levels of income have significantly higher prevalences of breast cancer specific physical and functional limitations (range of motion, strength, lymphedema, function, ability to accomplish functional tasks, pain and fatigue) than those with moderate to high income levels.
Aim 2 : Measure physical and functional well being/quality of life among AAs, poor and medically underserved BCS. H2.1: AAs report lower levels of physical and functional well being than non-minorities. H2.2: Those with low levels of income have significantly lower levels of physical and functional well being than those with moderate to high income levels.
Aim 3 : Determine the contributions of co-morbidity and barriers to health care utilization on breast cancer specific physical and functional limitations/symptoms and quality of life among AAs, the poor and medically underserved. H3.1: Those with high levels of co-morbidity have significantly higher prevalences of breast cancer specific physical and functional limitations/symptoms (range of motion, strength, lymphedema, pain, fatigue and ability to accomplish functional tasks) than those with low levels of comorbidity. H3.1a: Those with high levels of co-morbidity have significantly lower levels of physical and functional well being/quality of life than those with low levels of co-morbidity. H3.2: Those who have more barriers to health care utilization (no or limited health insurance, lack of regular medical examinations, transportation, regular place to receive health care services) have significantly higher prevalences of breast cancer specific physical and functional limitations and symptoms than those who have low barriers to health care utilization. H3.2a: Those who have more barriers to health care utilization (no or limited health insurance lack of regular medical examinations, transportation, regular place to receive health care services) have significantly lower rates of physical and functional well being/quality of life than those who have low barriers to health care utilization.
This study is the first of its kind to exclusively focus on physical and functional limitations and well being after breast cancer - two areas cited as most problematic in life after breast cancer. Our study will also be the first to partner with the Southern Community Cohort Study in order to incorporate large sub-samples of African American, poor and medically underserved breast cancer survivors - groups that are notably understudied in the breast cancer survivorship literature. The information from this study will help describe and fill a gap in cancer disparities research which will focus on physical and functional limitations and well-being.
| Flores, Ann Marie; Nelson, Jason; Sowles, Lee et al. (2016) Physical impairments and physical therapy services for minority and low-income breast cancer survivors. Springerplus 5:1227 |
