%0 Journal Article
%T Double Jeopardy? Age, Race, and HRQOL in Older Adults with Cancer
%A Keith M. Bellizzi
%A Noreen M. Aziz
%A Julia H. Rowland
%A Kathryn Weaver
%A Neeraj K. Arora
%A Ann S. Hamilton
%A Ingrid Oakley-Girvan
%A Gretchen Keel
%J Journal of Cancer Epidemiology
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/478642
%X Understanding the post-treatment physical and mental function of older adults from ethnic/racial minority backgrounds with cancer is a critical step to determine the services required to serve this growing population. The double jeopardy hypothesis suggests being a minority and old could have compounding effects on health. This population-based study examined the physical and mental function of older adults by age (mean age£¿=£¿75.7, SD£¿=£¿6.1), ethnicity/race, and cancer (breast, prostate, colorectal, and gynecologic) as well as interaction effects between age, ethnicity/race and HRQOL. There was evidence of a significant age by ethnicity/race interaction in physical function for breast, prostate and all sites combined, but the interaction became non-significant (for breast and all sites combined) when comorbidity was entered into the model. The interaction persisted in the prostate cancer group after controlling for comorbidity, such that African Americans and Asian Americans in the 75¨C79 age group report lower physical health than non-Hispanic Whites and Hispanic Whites in this age group. The presence of double jeopardy in the breast and all sites combined group can be explained by a differential comorbid burden among the older (75¨C79) minority group, but the interaction found in prostate cancer survivors does not reflect this differential comorbid burden. 1. Introduction By 2030, nearly one in five US residents will be >65 years of age and this group is projected to reach 72 million by that year, a doubling of the number in 2008 [1]. During this period, it is estimated that the percentage of all cancers diagnosed in older adults and ethnic/racial minorities will increase from 61% to 70% and from 21% to 28%, respectively [2]. Historically, older adults and minorities have been underrepresented in cancer clinical trials which can ultimately lead to disparities in treatment and outcomes. An important outcome that has received little attention is the posttreatment health-related quality of life (HRQOL) of older adults with cancer from minority backgrounds. The double jeopardy hypothesis suggests that being a minority and old could have additive negative effects on health outcomes [3¨C5]. Understanding the post-treatment burden of older adults and minorities with cancer is a critical step to determine the services and resources required to serve this rapidly growing population. While the long-term surveillance of older adults and minorities with cancer is limited, evidence suggests physical and social functioning are the most common HRQOL domains affected by
%U http://www.hindawi.com/journals/jce/2012/478642/