Older Black adults with cancer have higher rates of frailty and functional impairments 

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.  

Additional Information

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Full Citations:

“Racial Disparities in frailty and geriatric assessment impairments in older adults with cancer in the Deep South: Results from the CARE Registry.” Grant R. Williams, Mustafa Al-Obaidi, Christian Harmon, Chen Dai, Darryl Outlaw, Olumide Gbolahan, Moh’d Khushman, Kirsten A. Nyrop, Nikesha Gilmore, Smita Bhatia, and Smith Giri. CANCER; Published Online: April 11, 2022 (DOI: 10.1002/cncr.34178).

URL Upon Publication: http://doi.wiley.com/10.1002/cncr.34178

“Equity.” Jana Wieland, Barbara L. Jordan, and Aminah Jatoi. CANCER; Published Online: April 11, 2022 (DOI: 10.1002/cncr.34179).

URL Upon Publication: http://doi.wiley.com/10.1002/cncr.34179

Author Contact: Yvonne Taunton, UAB public relations specialist, at ytaunton@uab.edu

About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online.

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