Grant R01CA105266

Ethnicity, Breast Cancer Recurrence, &Long-Term QOL

DESCRIPTION (provided by applicant): This application proposes a follow-up study of the New Mexico Women's Health Study (NMWHS: 1992-1996), a statewide, population-based, case-control breast cancer study, for survival, recurrence, and quality of life (QOL) approximately 14 years (y) post-diagnosis. The NMWHS included 1,556 Hispanic (H) and non-Hispanic white (NHW) women. Women newly diagnosed with in situ or invasive breast carcinoma ascertained through the New Mexico Tumor Registry (NMTR) were eligible based on the following criteria: age 30-74y, diagnosis year 1992- 1994;and New Mexico (NM) resident at diagnosis. All H cases were included, and a 33% random sample of NHW cases was identified for inclusion. The sampling fraction for NHW cases was chosen to give a similar distribution to the H cases based on age and geographic distribution of H cases ascertained during an earlier 3-y period. Of the eligible cases, participation rates were 68% (n=332) for H cases;and 77% (n=380) for NHW cases. Controls were recruited using a modified version of the Waksberg random digit-dialing method, and were frequency-matched by ethnicity, age-group, and health planning district. Of the eligible controls, participation rates were 76% (n=388) for H cases and 86% (n=456) for NHW cases. Mean age at diagnosis for cases was 54y compared to 53y for controls. In an initial review of a 10% (n=156) random sample of NMWHS participants, only 9% of 142 classified as 'alive'were not located (deceased=14). Of the 'alive'group, 82% were located within NM. Based on these results, we estimate that there will be 670 subjects to be followed for survival, 430 for recurrence (517, if deceased are included), and 969 for QOL, assuming a 75% participation rate. An additional random 12.9% sample showed 93% still in NM. Recurrence will be ascertained through self-report and verified through medical records. New primaries will be ascertained through linkage with the NMTR. Mortality will be confirmed using the National Death Index. QOL measures will be based on a standardized questionnaire used in a previous breast cancer cohort study and conducted via telephone. The proposed follow-up study will provide a unique opportunity to evaluate factors influencing survival and recurrence in long-term breast cancer survivors, and QOL compared to population-based controls. Most important, the study will allow the comparison of H vs. NHW women for these outcomes and the interaction of ethnicity with other prognostic factors in an aging cohort. There are few studies of QOL in older, long-term breast cancer survivors, and no large studies that we are aware of that have compared QOL in cases with population-based controls. There are scant data comparing H with NHW women for these outcomes. The proposed study could have important implications for treatment of H vs. NHW women and long-term care of older breast cancer survivors.