Colorectal Cancer and Quality of Life: A Medicare Advantage Study by Race, Ethnicity, and Language
Emna Bakillah
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCorresponding Author
J. Walker Rosenthal
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Correspondence: J. Walker Rosenthal ([email protected])
Search for more papers by this authorSolomiya Syvyk
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Search for more papers by this authorChris Wirtalla
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Search for more papers by this authorJames Sharpe
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRaina M. Merchant
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Emergency Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorShivan J. Mehta
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Division of Gastroenterology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCarmen E. Guerra
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRachel Kelz
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorEmna Bakillah
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCorresponding Author
J. Walker Rosenthal
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Correspondence: J. Walker Rosenthal ([email protected])
Search for more papers by this authorSolomiya Syvyk
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Search for more papers by this authorChris Wirtalla
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Search for more papers by this authorJames Sharpe
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRaina M. Merchant
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Emergency Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorShivan J. Mehta
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Division of Gastroenterology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCarmen E. Guerra
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRachel Kelz
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Department of Surgery, Center for Surgery and Health Economics, Philadelphia, Pennsylvania, USA
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorABSTRACT
Background and Methods
Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016−2020). The exposure group answered “Yes” to the current CRC treatment and the control group answered “No.” The primary outcomes were physical component summary (PCS) and mental component summary (MCS) scores. Conditional effects by race and ethnicity were analyzed using interaction terms.
Results
Among 184 486 adults, 676 (0.4%) reported current CRC treatment. Those receiving treatment had significantly lower PCS scores (β coefficient −1.98, p < 0.001) and lower MCS scores (β coefficient −0.81, p = 0.018), compared to nontreatment. In the treatment group, Hispanic respondents and Spanish speakers had higher PCS scores (β coefficient 1.96, p = 0.019 and 3.19, p = 0.023, respectively), and respondents identifying as American Indian or Alaska Native had higher MCS scores (β coefficient 8.72, p = 0.016).
Conclusion
Individuals receiving CRC treatment exhibit worse HRQOL. Outcomes differed by race and ethnicity. This study suggests the need to invest in targeted interventions to improve overall HRQOL during treatment for CRC.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
Data sharing is not applicable to this article as no new data were created in this study. The data used in this study is available for request from the Center for Medicare and Medicare Services at https://www.cms.gov/data-research/research/health-outcomes-survey. The author's license does not permit sharing of this data.
Supporting Information
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