Despite efforts to address racial disparities related to cancer, Black Americans are more likely to die from cancer than most other groups. New research suggests that a partial explanation may be higher rates of frailty and functional impairments among older Black patients with cancer. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
In the study of 553 older adults who had recently been diagnosed with gastrointestinal cancer and were willing to be listed in a registry at the University of Alabama at Birmingham, 50.0% of Black participants and 32.7% of white participants were frail, meaning that they experienced an aging-related physiologic decline, with symptoms such as weakness and fatigue that put them at higher health risks.
Black participants were also twice as likely to report limitations in walking one block, basic self-care tasks of daily living (like dressing and bathing), and instrumental activities of daily living (such as housecleaning and shopping). Differences persisted even after adjusting for age, sex, education, cancer type, cancer stage, and comorbidities.
"As frailty and functional impairments are associated with increased chemotherapy toxicities, hospitalizations, and poorer overall survival, these differences may in part explain racial disparities in cancer outcomes," said lead author Grant R. Williams, MD, MSPH.
Additional research is needed to determine why frailty is more common in older Black individuals with cancer and to develop strategies to address it.
An accompanying editorial notes that the work provides a mandate for change. "Healthcare providers should work to incorporate geriatric assessment-driven interventions into clinical practice for older, frail patients-including those who appear to be at ostensibly higher risk because of racial considerations-with the goal of lessening these patients' side effects and improving their cancer outcomes," the authors wrote.
