Distress among African American and White adults with cancer in Louisiana

Abstract

Purpose/Objectives: Screening for distress is a key priority in cancer care, and African American patients may experience increased distress compared to White patients. However, this question has not yet been addressed in Louisiana. The purpose of the present study was to examine the relationship between African American race and distress at a cancer center in Louisiana.Design/Methods: This was a retrospective study of 1,544 patients who were treated at an academic cancer center in 2015. Extracted data included patient self-reports of distress using the single-item Distress Thermometer (DT) and demographic and clinical characteristics.Hypotheses were tested using logistic regression.Findings: Distress was present in 19.7% of the sample. In univariate analyses, African American patients were more likely than White patients to experience distress (OR=1.38, p=.013). However, race was no longer associated with distress in a multivariate analysis that adjusted for the covariates of age, gender, cancer site, presence of metastases, and number of distress screenings (OR=1.07, p=.670). Distress was more common in patients who were younger (OR=2.26, p<.001), diagnosed with lung/bronchus cancer (OR=5.28, p<.001), or screened more often (OR=5.20, p<. 001). Distress was less common among patients with female breast cancer (OR=0.39, p=.015).Conclusions/Implications: This study suggests that African American individuals with cancer in Louisiana are at increased risk for distress, but that this can be attributed to African American patients being younger, more likely to have lung cancer, and screened more frequently. Implications include careful consideration of patient race, age, and cancer site during distress management in cancer care.

Disparities in Psychosocial Distress Screening and Management of Lung and Ovarian Cancer Survivors

“…4,48,49,59 Consistent with the previous literature, this study found that the three most common reasons survivors reported feeling distressed were physical symptoms, emotional problems, and practical problems. 48,60 Although consistent with other literature, 61 our finding that nearly a third of non-Hispanic Black survivors declined psychosocial support is concerning because Black cancer survivors experience higher distress 62,63 and have more unmet psychosocial needs than White cancer survivors. 58 It is not clear from our data why survivors decline follow-up support, although stigma around mental illness may contribute and has been found to be higher among people from racial and ethnic minority groups than those from majority groups.…”

Characterization of Clinical Symptoms by Race Among Women With Early-Stage, Hormone Receptor–Positive Breast Cancer Before Starting Chemotherapy

“… 8 , 11 , 12 , 13 , 14 Several studies compared symptoms during or after chemotherapy by race/ethnicity and found mixed results. 12 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Symptom assessment timing varied in these studies (eg, during treatment vs later in survivorship), which may explain the inconsistent findings. To our knowledge, no studies have compared differences in patient-reported symptoms before starting chemotherapy.…”

African American Males Have More Distress During Cancer Treatment Than White Males

“…Many prior studies examining racial disparities and distress suffered from a small sample of AA patients. The DT is a validated tool also used in several other articles such as Perry et al (2020) and Weiss et al (2012), demonstrating reliable and effective results.…”

“…There has been little research on racial or socioeconomic status (SES) disparities of cancer patient distress in the United States. A recent study identified that AA cancer patients had higher odds of high distress compared with non-Hispanic Whites, but the significance disappeared with the multivariable model (Perry et al, 2020). Studies using health-related quality of life (HRQoL) reported AAs had lower mental scores and poorer survival compared with White patients (Belachew et al, 2020; Poghosyan et al, 2015).…”