Race and correlates of cancer cachexia in the Detroit Research on Cancer Survivors cohort.

Abstract

12094 Background: Cancer cachexia is a multifunctional syndrome characterized by the ongoing loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment limiting quality of life. It is also associated with poor response to therapies which impact long-term survival. The current investigation examines the prevalence and determinants of cachexia in a racially diverse cancer cohort. Methods: We used data gathered on a subset of participants in the Detroit Research on Cancer Survivors (ROCS) study, one of the largest cohorts conducted exclusively among Black cancer survivors to understand the complex nature of poorer outcomes in this population. At baseline, participants diagnosed and/or treated at the Karmanos Cancer Institute with breast, colorectal and lung cancer were asked to provide their weight one year prior to diagnosis and current weight, height, medical history, health behaviors and health-related quality of life (HRQOL). Responses were compared with a frequency-matched set of White cancer survivors. Cachexia was defined as an unintentional weight loss of 5% or more for patients with a BMI 20 or higher and 2% or more for patients with a BMI < 20 over 6 months. Results: Among 899 cancer survivors (509 Black and 390 White), 35.3% reported weight loss consistent with cachexia. A significantly higher proportion of Black survivors were cachectic (40.3%) compared with White survivors (28.7%; p < 0.001). Racial differences were equally pronounced regardless of tumor type, but overall the highest proportion of cachexia was observed among lung cancer survivors (54.2%). Examination of the electronic medical records of these patients found that older age at diagnosis (p-trend < 0.005) and a medical history of diabetes (OR = 2.18; 95%CI 1.31, 3.63) were both significantly associated with the presence of cachexia. Conclusions: We found that Black patients are more likely to have cachexia at the time of cancer diagnosis than white patients. Since cachexia is an important predictor of poor outcomes in cancer patients, developing strategies to prevent or reverse the loss in the skeletal muscle mass is critical in improving outcomes and reducing disparities in related outcomes.