Northwestern University Feinberg School of Medicine, Chicago, IL
Patricia Moreno , Amelie G. Ramirez , Frank J. Penedo
Background: Cardiometabolic illness is a leading cause of death among cancer survivors previously treated for early-stage breast, prostate, and colorectal cancer. Despite the fact that Hispanics/Latinos in the U.S. are at a significantly elevated risk for poor cardiometabolic health, there is a paucity of research examining cardiometabolic comorbidities in Hispanic/Latino cancer survivors. The aim of this study was to examine unmet supportive care needs and health behaviors in Hispanic/Latino cancer survivors with and without comorbid peripheral vascular disease and diabetes. Methods: Hispanics/Latinos diagnosed with breast, prostate, or colorectal cancer (N = 288) were assessed using the Charlson Comorbidity Index, Supportive Care Needs Survey, and ACS Lifestyle Behavior Scale within 15 months of treatment completion in an NCI-funded project. Logistic regression analyses were conducted adjusting for sociodemographic and medical covariates. Results: Most survivors had a high school education or less (65.6%) and a household income less than $50,000 (68.4%) and were foreign-born (59.4%) and either monolingual Spanish-speaking (54.2%) or English-Spanish bilingual (26.0%). One-quarter (24.7%) were diagnosed with comorbid diabetes and one-fifth (20.8%) were diagnosed with comorbid peripheral vascular disease. Survivors with peripheral vascular disease were more likely to have unmet health system and information needs (OR 2.29, p = .011) and unmet sexuality needs (OR 2.07, p = .020) and marginally more likely to have unmet psychological care needs (OR 1.71, p = .099) than those without peripheral vascular disease. Survivors with diabetes were more likely to have unmet sexuality needs (OR 2.06, p = .015) than those without diabetes. Survivors reported increasing some positive health behaviors following their diagnosis of cancer, including regular health check-ups (61.5%) and consumption of healthy foods like fruits and vegetables (61.8%). However, attempts to lose weight (45.1%), exercise (40.6%), and avoid alcohol (26.0%) and cigarettes (17.0%) were less common. Health behaviors did not vary between survivors with and without peripheral vascular disease and diabetes (p > .05). Conclusions: Comorbid peripheral vascular disease and diabetes are highly prevalent among Hispanic/Latino cancer survivors and are associated with greater unmet supportive care needs. Targeted efforts are needed to increase exercise and weight loss as well as reduce smoking and alcohol consumption in Hispanic/Latino cancer survivors.
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