Abstract PO-229: Racial/ethnic differences in tumor characteristics among endometrial cancer patients in an equal-access healthcare population

IntroductionCancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss and changes in health insurance and may not be uniformly experienced. We examined racial/ethnic differences in the financial consequences of employment disruption.MethodsWe surveyed a national sample of cancer patients employed at diagnosis who had received assistance from a national nonprofit about the impact of cancer diagnosis and treatment on employment. We used logistic regression models to examine racial/ethnic differences in income loss and changes in health insurance coverage.ResultsOf 619 cancer patients included, 63% identified as Non-Hispanic/Latinx (NH) White, 18% as NH Black, 9% as Hispanic/Latinx, 5% as other racial/ethnic identities, and 5% unreported. Over 83% reported taking a significant amount of time off from work during cancer diagnosis and treatment, leading to substantial income loss for 64% and changes in insurance coverage for 31%. NH Black respondents had a 10.2 percentage point (95% CI: 4.8 – 19.9) higher probability of experiencing substantial income loss compared to NH White respondents, and Hispanic or Latinx respondents had a 12.4 percentage point (95% CI: 0.3 – 24.5) higher probability compared to NH White respondents, controlling for clinical characteristics (i.e., cancer type, stage and age at diagnosis, and time since diagnosis). Similarly, NH Black respondents had a 9.3 percentage point (95% CI: -0.7 – 19.3) higher probability of experiencing changes in health insurance compared to NH White respondents, and Hispanic or Latinx respondents had a 10.0 percentage point (95% CI: -3.0 – 23.0) higher probability compared to NH White respondents.DiscussionCompared with NH White respondents, NH Black and Hispanic/Latinx respondents more commonly reported employment-related income loss and health insurance changes. Given documented racial/ethnic differences in job types, benefit generosity, and employment protections as a result of historic marginalization, policies to reduce employment disruption and its associated financial impact must be developed with a racial equity lens.

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Breast pain in a diverse population of breast cancer patients

10.21203/rs.3.rs-36629/v1 ◽

2020 ◽

Author(s):

Jami Fukui ◽

Erin Bantum ◽

Madison Meister ◽

Shannon Lim ◽

Ashley Davidson Marumoto ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Ethnic Differences ◽

Short Form ◽

Mcgill Pain Questionnaire ◽

Diverse Population ◽

Breast Pain ◽

Breast Cancer Patients ◽

Early Stage Disease ◽

Racial Ethnic

Abstract Background Breast cancer is the most common cancer in women. The majority of women with breast cancer present with early stage disease requiring surgical management. Post-operative breast pain has been reported to be anywhere from 25–60%. Racial disparities in cancer treatment-related symptom burden are known and linked to worse treatment outcomes. There is sparse data regarding racial/ethnic differences in breast pain among breast cancer patients. We evaluated the prevalence of breast pain in breast cancer patients and characterized the pain using a modified short-form McGill pain questionnaire in our diverse population. Methods We performed a cross sectional study, including 237 patients from various outpatient oncology clinics and breast cancer survivorship groups on Oahu and Maui. Participants had the option to complete the survey in person at the clinic or online. Results Eight-four respondents (35.4%) reported breast pain. There were no statistical differences seen in breast pain likelihood according to racial/ethnic group. On multivariate analysis, we did however find significant racial/ethnic differences in the amount of breast pain, where Chinese, Native Hawaiian and Mixed Asian participants reported significantly less pain compared to White participants (1.36, 2.16 and 2.22 vs 2.92, p = < 0.0001, 0.03 and 0.05) on a 10-point pain scale. We found differences in breast pain according to age, chemotherapy, radiation therapy and endocrine therapy use as well as survey location. No differences were seen according to the type of breast or axillary surgery. The most common descriptors of breast pain were sensory compared to affective characteristics. The average self-reported pain score found was 3/10. Overall, in women with breast pain, 33.4% reported the breast pain affected their sleep with 16.7% reporting it affected their work and 15.4% reporting it affected their sexual activity. Conclusions Breast pain is a significant problem in our breast cancer community. This survey assessment has informed our understanding of breast pain in our diverse population. In turn we are developing culturally appropriate pain management strategies to treat this challenging symptom common in breast cancer survivors.

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