Trends in Racial and Ethnicity Disparities in the Health-Related Quality of Life of Older Adults with Breast Cancer: A Seer-Mhos National Database Study

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 over 65 years old with breast cancer who completed the Health Outcomes Survey within 24 months pre- and post-diagnosis and reported as non-Hispanic white, non-Hispanic Asian or Pacific Islander, non-Hispanic black or African American, or Hispanic (n = 1,999). HRQOL was measured by the Physical and Mental Component Summary (PCS, MCS). Univariable and multivariable linear regression models assessed disparities between races and ethnicities.Results: All racial/ethnic groups showed a numerical drop in PCS and MCS scores pre- and post-diagnosis. Among pre-diagnosis patients with stage IV breast cancer, race was a predictor of PCS with overall significance (p = 0.04). Specifically, White patients had higher pre-diagnosis PCS scores than Black patients (+13.32, p = 0.03). Race/ethnicity was not a significant predictor of PCS or MCS scores otherwise.Conclusion: In patients 65 years and older diagnosed with stage IV breast cancer, White patients had better physical HRQOL than Black patients pre-diagnosis (p = 0.04). Otherwise, race and ethnicity were not significant predictors of HRQOL scores. Fewer comorbidities and higher ADL functioning correlated with higher MCS and PCS scores. The decrease in HRQOL scores post-diagnosis across all groups highlights the need for appropriate resources and support to improve HRQOL following diagnosis.