African-American Women with Newly Diagnosed Breast Cancer Have Poor Physical Performance
CHICAGO—In a population of older women with newly diagnosed breast cancer, poor physical performance was highly prevalent, a cross-sectional study of ambulatory oncology clinics within a single academic institution presented at the 2013 American Society of Clinical Oncology (ASCO) Annual Meeting has found.
“Relative to non-Hispanic whites, older African-American women were nearly 1.5 times more likely to have poorer physical performance at diagnosis of breast cancer,” noted Cynthia Owusu, MD, MS, of Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH, and colleagues.
Women aged 65 years and older with newly diagnosed stage I-III breast cancer and ability to provide informed consent were included in the study; African-American women were oversampled.
Of the 107 women included in the analysis, mean age was 74.9 years, 32% were African American, 39% had less than a high school education, 57% were current or previous smokers, and 44% had a body mass index of 30 kg/m2 or higher, with 50% reporting fewer than 500 metabolic equivalent minutes per week of physical activity. Mean baseline serum C-reactive protein (CRP) level was 0.71 mg/mL. The majority of the patients had stage I-II disease (91%); 96% underwent primary breast surgery. Mean comorbidity count was 3.9, and 19% had two or more geriatric syndromes.
The study found that the association between race and physical performance remained after adjusting for age, educational status, comorbidity count, and geriatric syndromes, and that inflammation, as measured by CRP, partly medicated the association between race and physical performance. Physical activity was found to be a mediator of the association between race and physical performance (P<0.0001).
“Racial differences in physical performance was partly explained by racial differences in educational status, chronic medical conditions, subclinical inflammation, and physical activity,” Dr. Owusu concluded.