The impact of a second primary cancer diagnosis on health-related quality of life in African American cancer survivors.

Abstract

11133 Background: Survival for the most common cancers has improved dramatically over the past several decades due to advances in treatment and screening for early detection. An unintended consequence of this is that survivors now face a greater possibility of developing one or more new primary cancers in their lifetime. It has been estimated that up to 22% of cancer survivors will be diagnosed with multiple primary cancers (MPCs). Understanding the impact of these diagnoses on outcomes along the survivorship continuum is important in developing tools to mitigate risks. Methods: The Detroit Research on Cancer Survivors (ROCS) cohort has enrolled more than 5,000 Black cancer survivors to understand the multiplex causes of poor outcomes in this high-risk population. Detroit ROCS participants are surveyed annually following enrollment to update medical history and mental health outcomes including health-related quality of life (HRQOL) measured using the Functional Assessment of Cancer Therapy (FACT-G) survey. In addition, regular linkages with the Metropolitan Detroit Cancer Surveillance System (MDCSS) registry are used to identify second primary cancer diagnosis, confirm self-reports, and gather relevant clinical data. The ROCS cohort is in its 9th year of potential follow-up. In 2024, the Detroit Genetic Epidemiology of Multiple primary cancers (GEMS) study was funded to examine susceptibility to MPCs leveraging Detroit ROCS to identify first primary breast, prostate and colorectal cancer survivors diagnosed with a second primary cancer. Analyses included comparisons of HRQOL and other characteristics 1) between MPCs and a frequency-matched (3:1) subset of single primary cancer (SPC) cancer cases; and 2) among MPCs, using survey data collected before and after their second diagnosis. Results: To date, Detroit GEMS includes 371 Black MPCs confirmed in MDCSS. The most common second primary cancer diagnosed among survivors was breast, followed by colorectal, lung and hematologic cancers. No significant differences were observed between MPCs and SPCs in the total FACT-G score, however when evaluating FACT-G subscales MPCs reported a significantly lower mean functional well-being score (16.9 and 18.0, respectively; p=0.022). Similar findings were observed in a subset of 104 MPCs with functional well-being scores reported before and after their second diagnosis (18.0 and 16.1, respectively; p=0.004). Conclusions: Cancer survivors diagnosed with a MPC report similar HRQOL compared with survivors with a SPC, suggesting resiliency in Black cancer survivors which is encouraging. However, understanding factors that contribute to declining functional well-being will be important in early interventions to improve overall quality of life.