Abstract
Latinas have lower quality of life than Caucasian cancer survivors but we know little about factors associated with quality of life in this growing population. Bilingual staff conducted interviews with a national cross-sectional sample of 264 Latina breast cancer survivors. Quality of life was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B). Regression models evaluated associations between culture, social and medical context and overall quality of life and its subdomains. Latina survivors were 1–5 years post-diagnosis and reported a lower mean quality of life score compared to other published reports of non-Latina survivors (M = 105; SD = 19.4 on the FACT-B). Culturally based feelings of breast cancer-related stigma and shame were consistently related to lower overall quality of life and lower well-being in each quality of life domain. Social and medical contextual factors were independently related to quality of life; together cultural, social and medical context factors uniquely accounted for 62 % of the explained model variance of overall quality of life (Adjusted R 2 = 0.53, P < 0.001). Similar relationships were seen for quality of life subdomains in which cultural, social, and medical contextual variables independently contributed to the overall variance of each final model: physical well-being (Adjusted R 2 = 0.23, P < .001), social well-being (Adjusted R 2 = 0.51, P < 0.001), emotional well-being (Adjusted R 2 = 0.28, P < 0.001), functional well-being (Adjusted R 2 = 0.41, P < 0.001), and additional breast concerns (Adjusted R 2 = 0.40, P < 0.001). Efforts to improve Latinas’ survivorship experiences should consider cultural, social, and medical contextual factors to close existing quality of life gaps between Latinas and other survivors.
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Acknowledgments
This work was supported by Susan G. Komen for the Cure #POP0601292 and NIH Grants NCI#K07CA131172 (KDG), NCI#U01CA114593 and NCI#K05CA96940 (JM). We appreciate the time and openness of the Latina breast cancer survivors who participated in this study. We thank the Dr. Susan Love Research Foundation’s Army of Women, Nueva Vida, Inc, Las Comadres, Breast Cancer Resource Centers of Texas, Sustainable Food Center (Austin, TX), Mercy Ministries, LatinaSHARE, and the numerous hospitals and community agencies for connecting us to Latina breast cancer survivors. Finally, we thank Susan Marx for her assistance with manuscript preparation.
Conflict of interest
Florencia Gonzalez, MPH and Larisa Caicedo, MA work for Nueva Vida, Inc. a non-profit agency that provides services to Latina breast cancer survivors. The authors declare that they have no other conflicts of interest.
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Graves, K.D., Jensen, R.E., Cañar, J. et al. Through the lens of culture: quality of life among Latina breast cancer survivors. Breast Cancer Res Treat 136, 603–613 (2012). https://doi.org/10.1007/s10549-012-2291-2
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DOI: https://doi.org/10.1007/s10549-012-2291-2