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Obesity, ethnicity, and quality of life among breast cancer survivors and women without breast cancer: the long-term quality of life follow-up study

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Abstract

Purpose

The purpose of this study was to examine the relationship between obesity and quality of life (QOL) among Hispanic and non-Hispanic white breast cancer survivors and population-based controls from the ‘Long-Term Quality of Life Study’—a 12- to 15-year follow-up study of breast cancer cases/survivors and controls from New Mexico (n = 451).

Methods

Using multiple linear regressions, obesity measures [body mass index (BMI) ≥ 30 kg/m2] at baseline and follow-up interview were modeled with composite scores for physical and mental health from the SF-36 Quality of Life Survey. Interaction between ethnicity and BMI and change in BMI were evaluated. All models were adjusted for age, ethnicity, Charlson Index, depression, fatigue, and physical activity.

Results

Baseline obesity (β = −6.58, p = 0.04) was significantly associated with decreased mental health among survivors, but not among controls. Obesity at baseline and follow-up were significantly associated with decreased physical health among survivors (baseline β = −10.51, p = 0.004; follow-up β = −7.16, p = 0.02) and controls (baseline β = −11.07, p < 0.001; follow-up β = −5.18, p = 0.04). No significant interactions between ethnicity and BMI were observed.

Conclusions

Our findings provide unique information about a diverse population of breast cancer survivors and controls and the impact of obesity on the mental and physical aspects of QOL.

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Abbreviations

BMI:

Body mass index

LTQOL:

Long-Term Quality of Life Study

MET:

Metabolic equivalent

NMTR:

New Mexico Tumor Registry

NMWHS:

New Mexico Women’s Health Study

NHW:

Non-Hispanic white

SE:

Standard error

SEER:

Surveillance, Epidemiology and End Results

QOL:

Quality of life

References

  1. DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL, Alteri R, Robbins AS, Jemal A (2014) Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin 64(4):252–271. doi:10.3322/caac.21235

    Article  PubMed  Google Scholar 

  2. Mosher CE, Sloane R, Morey MC, Snyder DC, Cohen HJ, Miller PE, Demark-Wahnefried W (2009) Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors. Cancer 115(17):4001–4009. doi:10.1002/cncr.24436

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ooi SL, Martinez ME, Li CI (2011) Disparities in breast cancer characteristics and outcomes by race/ethnicity. Breast Cancer Res Treat 127(3):729–738. doi:10.1007/s10549-010-1191-6

    Article  PubMed  PubMed Central  Google Scholar 

  4. Li CI, Malone KE, Daling JR (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163(1):49–56

    Article  PubMed  Google Scholar 

  5. Huerta EE (2003) Cancer statistics for Hispanics, 2003: good news, bad news, and the need for a health system paradigm change. CA Cancer J Clin 53(4):205–207

    Article  PubMed  Google Scholar 

  6. Napoles-Springer AM, Ortiz C, O’Brien H, Diaz-Mendez M, Perez-Stable EJ (2007) Use of cancer support groups among Latina breast cancer survivors. J Cancer Surviv Res Pract 1(3):193–204. doi:10.1007/s11764-007-0029-7

    Article  Google Scholar 

  7. Lopez-Class M, Gomez-Duarte J, Graves K, Ashing-Giwa K (2012) A contextual approach to understanding breast cancer survivorship among Latinas. Psycho-oncology 21(2):115–124. doi:10.1002/pon.1998

    Article  PubMed  PubMed Central  Google Scholar 

  8. Yanez B, Thompson EH, Stanton AL (2011) Quality of life among Latina breast cancer patients: a systematic review of the literature. J Cancer Surviv Res Pract 5(2):191–207. doi:10.1007/s11764-011-0171-0

    Article  Google Scholar 

  9. Graves KD, Jensen RE, Canar J, Perret-Gentil M, Leventhal KG, Gonzalez F, Caicedo L, Jandorf L, Kelly S, Mandelblatt J (2012) Through the lens of culture: quality of life among Latina breast cancer survivors. Breast Cancer Res Treat 136(2):603–613. doi:10.1007/s10549-012-2291-2

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rao AV, Demark-Wahnefried W (2006) The older cancer survivor. Critical Rev Oncol Hematol 60(2):131–143. doi:10.1016/j.critrevonc.2006.06.003

    Article  Google Scholar 

  11. Carver CS, Smith RG, Petronis VM, Antoni MH (2006) Quality of life among long-term survivors of breast cancer: different types of antecedents predict different classes of outcomes. Psycho-oncology 15(9):749–758. doi:10.1002/pon.1006

    Article  PubMed  Google Scholar 

  12. Mehnert A, Koch U (2008) Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. J Psychosom Res 64(4):383–391. doi:10.1016/j.jpsychores.2007.12.005

    Article  PubMed  Google Scholar 

  13. Mols F, Vingerhoets AJ, Coebergh JW, van de Poll-Franse LV (2005) Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer 41(17):2613–2619. doi:10.1016/j.ejca.2005.05.017

    Article  PubMed  Google Scholar 

  14. Paskett E, Herndon J II, Donohue K, Naughton M, Grubbs S, Pavy M, Hensley M, Stark N, Kornblith A, Bittoni M, for C, Leukemia Group B (2009) Health-related quality of life in long-term breast cancer survivors: differences by adjuvant chemotherapy dose in Cancer and Leukemia Group B study 8541. Cancer 115(5):1109–1120. doi:10.1002/cncr.24140

  15. Ashing-Giwa KT, Padilla GV, Bohorquez DE, Tejero JS, Garcia M (2006) Understanding the breast cancer experience of Latina women. J Psychosoc Oncol 24(3):19–52. doi:10.1300/J077v24n03_02

    Article  PubMed  Google Scholar 

  16. Lopez-Class M, Perret-Gentil M, Kreling B, Caicedo L, Mandelblatt J, Graves KD (2011) Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care. J Cancer Educ 26(4):724–733. doi:10.1007/s13187-011-0249-4

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bellizzi KM, Rowland JH, Jeffery DD, McNeel T (2005) Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol 23(34):8884–8893. doi:10.1200/JCO.2005.02.2343

    Article  PubMed  Google Scholar 

  18. Maskarinec G, Murphy S, Shumay DM, Kakai H (2001) Dietary changes among cancer survivors. Eur J Cancer Care 10(1):12–20

    Article  CAS  Google Scholar 

  19. Holmes MD, Kroenke CH (2004) Beyond treatment: lifestyle choices after breast cancer to enhance quality of life and survival. Women’s Health Issues 14(1):11–13. doi:10.1016/j.whi.2003.12.004

  20. Paxton RJ, Phillips KL, Jones LA, Chang S, Taylor WC, Courneya KS, Pierce JP (2012) Associations among physical activity, body mass index, and health-related quality of life by race/ethnicity in a diverse sample of breast cancer survivors. Cancer 118(16):4024–4031. doi:10.1002/cncr.27389

    Article  PubMed  PubMed Central  Google Scholar 

  21. Smith AW, Alfano CM, Reeve BB, Irwin ML, Bernstein L, Baumgartner K, Bowen D, McTiernan A, Ballard-Barbash R (2009) Race/ethnicity, physical activity, and quality of life in breast cancer survivors. Cancer Epidemiol Biomark Prev 18(2):656–663. doi:10.1158/1055-9965.EPI-08-0352

    Article  Google Scholar 

  22. Gilliland FD, Hunt WC, Baumgartner KB, Crumley D, Nicholson CS, Fetherolf J, Samet JM (1998) Reproductive risk factors for breast cancer in Hispanic and non-Hispanic white women: the New Mexico Women’s Health Study. Am J Epidemiol 148(7):683–692

    Article  PubMed  CAS  Google Scholar 

  23. Li R, Gilliland FD, Baumgartner K, Samet J (2002) Hormone replacement therapy and breast carcinoma risk in Hispanic and non-Hispanic women. Cancer 95(5):960–968. doi:10.1002/cncr.10791

    Article  PubMed  CAS  Google Scholar 

  24. Gilliland FD, Li YF, Baumgartner K, Crumley D, Samet JM (2001) Physical activity and breast cancer risk in hispanic and non-hispanic white women. Am J Epidemiol 154(5):442–450

    Article  PubMed  CAS  Google Scholar 

  25. Baumgartner KB, Annegers JF, McPherson RS, Frankowski RF, Gilliland FD, Samet JM (2002) Is alcohol intake associated with breast cancer in Hispanic women? The New Mexico Women’s Health Study. Ethn Dis 12(4):460–469

    PubMed  Google Scholar 

  26. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee (1995). World Health Organ Tech Rep Ser 854:1–452

  27. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32(9 Suppl):S498–S504

    Article  PubMed  CAS  Google Scholar 

  28. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383

    Article  PubMed  CAS  Google Scholar 

  29. Hays RD, Sherbourne CD, Mazel RM (1993) The RAND 36-Item Health Survey 1.0. Health Econ 2(3):217–227

    Article  PubMed  CAS  Google Scholar 

  30. Ganz PA, Day R, Ware JE Jr, Redmond C, Fisher B (1995) Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. J Natl Cancer Inst 87(18):1372–1382

    Article  PubMed  CAS  Google Scholar 

  31. Goodwin PJ, Black JT, Bordeleau LJ, Ganz PA (2003) Health-related quality-of-life measurement in randomized clinical trials in breast cancer–taking stock. J Natl Cancer Inst 95(4):263–281

    Article  PubMed  Google Scholar 

  32. Hosmer D, Lemeshow S (1989) Applied logistic regression. Wiley, New York

    Google Scholar 

  33. Blanchard CM, Stein K, Courneya KS (2010) Body mass index, physical activity, and health-related quality of life in cancer survivors. Med Sci Sports Exerc 42(4):665–671. doi:10.1249/MSS.0b013e3181bdc685

    Article  PubMed  Google Scholar 

  34. Sirtori A, Brunani A, Villa V, Berselli ME, Croci M, Leonardi M, Raggi A (2012) Obesity is a marker of reduction in QoL and disability. Sci World J 2012:167520. doi:10.1100/2012/167520

    Article  Google Scholar 

  35. Imayama I, Alfano CM, Neuhouser ML, George SM, Wilder Smith A, Baumgartner RN, Baumgartner KB, Bernstein L, Wang CY, Duggan C, Ballard-Barbash R, McTiernan A (2013) Weight, inflammation, cancer-related symptoms and health related quality of life among breast cancer survivors. Breast Cancer Res Treat 140(1):159–176. doi:10.1007/s10549-013-2594-y

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  36. Center for Disease Control and Prevention (CDC): National Center for Chronic Disease Prevention and Health Promotion (2009) The power of prevention: chronic disease…the public health challenge of the 21st century. http://www.cdc.gov/chronicdisease/pdf/2009-power-of-prevention.pdf

  37. Aziz NM, Rowland JH (2003) Trends and advances in cancer survivorship research: challenge and opportunity. Semin Radiat Oncol 13(3):248–266. doi:10.1016/S1053-4296(03)00024-9

    Article  PubMed  Google Scholar 

  38. Luckett T, Goldstein D, Butow PN, Gebski V, Aldridge LJ, McGrane J, Ng W, King MT (2011) Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncol 12(13):1240–1248. doi:10.1016/S1470-2045(11)70212-1

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the Long-Term Quality of Life (LTQOL) research team, Dr. Nandita Das, Dr. Dongyan Yang, Mrs. Kimberly Warren, and the participants of the study for their contributions.

Funding

The work was supported by the following grants: NIH/NCI, R01-CA55730 The New Mexico Women’s Health Study. NIH/NCI, 1 R01-CA105266 Ethnicity, Breast Cancer Recurrence and Long-Term Quality of Life. Susan G. Komen Breast Cancer Disparities Epidemiology Research Training Program, Grant: KG090926.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Office E-6137, Baltimore, MD, USA

    Avonne E. Connor

  2. Department of Epidemiology and Population Health, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA

    Richard N. Baumgartner, Christina M. Pinkston, Stephanie D. Boone & Kathy B. Baumgartner

  3. Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21205, USA

    Avonne E. Connor

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  1. Avonne E. Connor
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  2. Richard N. Baumgartner
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  5. Kathy B. Baumgartner
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Corresponding author

Correspondence to Avonne E. Connor.

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The authors declare that they have no conflict of interest.

Additional information

Avonne E. Connor previously affiliated with University of Louisville, School of Public Health and Information Sciences, Department of Epidemiology and Population Health.

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Connor, A.E., Baumgartner, R.N., Pinkston, C.M. et al. Obesity, ethnicity, and quality of life among breast cancer survivors and women without breast cancer: the long-term quality of life follow-up study. Cancer Causes Control 27, 115–124 (2016). https://doi.org/10.1007/s10552-015-0688-z

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  • DOI: https://doi.org/10.1007/s10552-015-0688-z

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