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Cancer experiences and health-related quality of life among racial and ethnic minority survivors of young adult cancer: a mixed methods study

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Abstract

Purpose

Young adult (YA) racial and ethnic minority survivors of cancer (diagnosed ages 18–39) experience significant disparities in health outcomes and survivorship compared to non-minorities of the same age. However, little is known about the survivorship experiences of this population. The purpose of this study is to explore the cancer experiences and health-related quality of life (HRQOL) among YA racial/ethnic minorities in an urban US city.

Methods

Racial and ethnic minority YA cancer survivors (0 to 5 years posttreatment) were recruited from a comprehensive cancer center using a purposive sampling approach. Participants (n = 31) completed semi-structured interviews, the FACT-G (physical, emotional, social well-being) and the FACIT-Sp (spiritual well-being). Mixed methods data were evaluated using thematic analysis and analysis of covariance (ANCOVA).

Results

The majority of survivors were women (65 %), single (52 %), and Hispanic (42 %). Across interviews, the most common themes were the following: “changes in perspective,” “emotional impacts,” “received support,” and “no psychosocial changes.” Other themes varied by racial/ethnic subgroups, including “treatment effects” (Hispanics), “behavior changes” (Blacks), and “appreciation for life” (Asians). ANCOVAs (controlling for gender and ECOG performance status scores) revealed that race/ethnicity had a significant main effect on emotional (P = 0.05), but not physical, social, or spiritual HRQOL (P > 0.05).

Conclusions

Our findings suggest that minority YA cancer survivors report complex positive and negative experiences. In spite of poor health outcomes, survivors report experiencing growth and positive change due to cancer. Variations in experiences and HRQOL highlight the importance of assessing cultural background to tailor survivorship care among YA racial and ethnic minorities.

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Acknowledgments

The authors would like to thank the young adult cancer survivors who participated in the research project and shared their views and experiences. The authors would also like to thank Jennifer Beaumont for providing her expertise on the analyses for the quantitative data.

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Correspondence to Alexis R. Munoz.

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Conflict of interest

The authors have no financial disclosures or conflicts of interest to report. We have full control of all primary data and agree to allow the journal to view the data if requested.

Funding source

Research reported in this publication was supported by the American Cancer Society-Illinois Division under award number PSB-08-15, the National Cancer Institute of the NIH under award number K07CA158008, and a portion of Dr. Garcia’s time was supported by the National Center for Complementary and Alternative Medicine and the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number U54AR057951-S1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Munoz, A.R., Kaiser, K., Yanez, B. et al. Cancer experiences and health-related quality of life among racial and ethnic minority survivors of young adult cancer: a mixed methods study. Support Care Cancer 24, 4861–4870 (2016). https://doi.org/10.1007/s00520-016-3340-x

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