Assessing Racial Differences in Psychological Distress and Problem Items among Breast Cancer Survivors at Adjuvant...

The purpose of this study was to examine if there were racial differences in overall distress and problem items among Black and White breast cancer survivors at the time of adjuvant endocrine therapy (AET) initiation.

Data were analyzed from the Women's Hormonal Initiation and Persistence study, an observational trial of hormone receptor-positive breast cancer survivors. Participants completed the National Comprehensive Cancer Network's Distress Thermometer and its 36-item problem list. Multiple logistic regression was used to predict high distress (a score of ≥ 4 on the distress thermometer) by race, adjusting for sociodemographic and clinical characteristics. Descriptive statistics were computed by race (Black vs. White) for problem items reported by breast cancer survivors. χ2 tests were used to test racial differences in problem items.

Of the 572 participants, 72% were White and 28% were Black. More than half of the sample (52%) reported high distress. Race was not a significant predictor of distress in either the univariate or the multivariable analysis. The top 5 problem items for the overall sample included sleep (50.5%), fatigue (48.6%), worry (41.6%), dry/itchy skin (39.9%), and pain (37.8%). There were no statistically significant differences in the problem items endorsed by Black and White breast cancer survivors.

Survivors reported high levels of distress and physical problem items at the time of AET initiation regardless of race. Future work should focus on the development of interventions targeting specific problem items that contribute to distress among breast cancer survivors on AET.