Disparities in Quality of Life between Asian American and Non-Hispanic White American Breast Cancer Survivors

Abstract Background: Quality of life comparisons with non-Hispanic White (NHW) breast cancer survivors remain limited for Asian Americans, particularly across diverse subgroups, potentially obscuring important disparities. This study investigated ethnic disparities in quality of life among breast cancer survivors, focusing on Chinese, Vietnamese, and Japanese Americans compared with NHW survivors. Methods: Participants (N = 403) completed the Functional Assessment of Cancer Therapy–General (FACT-G) and the SF-36 Health Survey. The FACT-G total score assessed cancer-specific quality of life while the SF-36 component scores included the Physical Component Summary (PCS) and Mental Component Summary (MCS), representing physical and mental health–related quality of life. Results: After controlling for clinical covariates (Ps < .05), Asian Americans scored lower on all three outcomes (FACT-G, and PCS, MCS) than NHWs (ps < .05); Chinese and Vietnamese Americans also scored lower on all three outcomes than NHWs (all Ps < .05). Financial hardship, lower education, and not being employed full-time were associated with lower FACT-G, PCS, and MCS. Adjustment for these social determinant factors attenuated or eliminated group differences. Conclusions: Findings highlight disparities in quality of life among Asian American cancer survivors, challenging the model minority stereotype. The attenuation of group differences after adjustment for social determinants suggests that socioeconomic factors play an important role in observed disparities, underscoring the need for targeted interventions. Impact: Under-representation in research may mask disparities in quality of life and social determinants among Asian American survivors, underscoring the need for more inclusive study designs.