Use of non-prescription analgesic medications and survival among Black women with ovarian cancer.

Background:Existing literature examining analgesic medication use and epithelial ovarian cancer (EOC) risk has been inconsistent, with the majority of studies reporting an inverse association. Race-specific effects of this relationship have not been adequately addressed.Methods:Utilising data from the largest population-based case–control study of EOC in African Americans, the African American Cancer Epidemiology Study, the relationship between analgesic use (aspirin, non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen) and risk of EOC was estimated by multivariate logistic regression. The association of frequency, duration, and indication of analgesic use on EOC risk was also assessed.Results:Aspirin use, overall, was associated with a 44% lower EOC risk (OR=0.56; 95% CI=0.35–0.92) and a 26% lower EOC risk was observed for non-aspirin NSAID use (OR=0.74; 95% CI=0.52–1.05). The inverse association was strongest for women taking aspirin to prevent cardiovascular disease and women taking non-aspirin NSAIDs for arthritis. Significantly decreased EOC risks were observed for low-dose aspirin use, daily aspirin use, aspirin use for <5 years, and occasional non-aspirin NSAID use for a duration of ⩾5 years. No association was observed for acetaminophen use.Conclusions:Collectively, these findings support previous evidence that any NSAID use is inversely associated with EOC risk.

Ovarian cancer survival among Black women is the lowest across all racial and ethnic groups. Poor dietary quality also disproportionately affects Black populations, but its association with ovarian cancer survival in this population remains largely unknown. To examine associations between dietary patterns and survival among Black women diagnosed with epithelial ovarian cancer (EOC). This prospective cohort study was conducted among self-identified Black women aged 20 to 79 years newly diagnosed with histologically confirmed EOC in the African American Cancer Epidemiology Study (AACES) between December 2010 and December 2015, with follow-up until October 2022. AACES is a population-based study of ovarian cancer risk and survival among Black women in 11 US regions. Data were analyzed from March 2023 to June 2024. Dietary patterns were assessed by the Healthy Eating Index-2020 (HEI-2020) and Alternative Healthy Eating Index-2010 (AHEI-2010), with scores calculated based on dietary intake in the year prior to diagnosis and collected via the validated Block 2005 Food Frequency Questionnaire. Higher scores indicate better dietary quality. Hazard ratios (HRs) and 95% CIs were estimated from multivariable Cox models for the association between adherence to dietary recommendations and overall mortality among all participants and those with high-grade serous ovarian cancer (HGSOC). Among 483 Black women with EOC (mean [SD] age, 58.1 [10.5] years), 310 deaths were recorded during a median (IQR) follow-up of 4.3 (2.0-8.2) years. No association of dietary patterns with mortality was found among women with EOC overall. However, among 325 women with HGSOC, better adherence to HEI-2020 was associated with decreased mortality in later quartiles compared with the first quartile (HR, 0.63; 95% CI, 0.44-0.92 for quartile 2; HR, 0.67; 95% CI, 0.46-0.97 for quartile 3; HR, 0.63; 95% CI, 0.44-0.91 for quartile 4 ). Similar results were observed with AHEI-2010 among women with HGSOC for the second (HR, 0.62; 95% CI, 0.43-0.89) and fourth (HR, 0.67; 95% CI, 0.45-0.98) quartiles compared with quartile 1. In this study, women with moderate and high prediagnosis dietary quality had significantly lower mortality rates from HGSOC compared with women with the lowest prediagnosis dietary quality. These findings suggest that even moderate adherence to dietary guidelines prior to diagnosis may be associated with improved survival among Black women with HGSOC, the most lethal form of ovarian cancer.

Cigarette smoking in relation to survival in Black women with ovarian cancer: Evidence from the African American Cancer Epidemiology Study (AACES).

Introduction: Black women with epithelial ovarian cancer (EOC) have worse survival compared to other racial groups, and the causes of these poor outcomes remain unclear. Compared to other racial groups, Black women are disproportionately affected by comorbid conditions which can adversely impact cancer care and outcomes. Thus, we examined the association of pre-diagnostic comorbid conditions and their associated medications with survival among Black women with EOC. Methods: Using data from Black women with EOC in the African American Cancer Epidemiology Study, we evaluated the self-reported Charlson comorbidity index (CCI) and three cardiometabolic comorbidities (diabetes mellitus, hypertension, and hyperlipidemia). We also characterized whether women with each cardiometabolic condition were using medication for their condition. Kaplan-Meier survival curves and log-rank tests were used to examine survival by the CCI, each cardiometabolic comorbidity, and medication use. Cox proportional hazards regression models were used to examine the association of comorbid conditions and medications with survival while adjusting for age at diagnosis, stage, histotype, and study site. Results: Among 592 Black women with EOC, 35% had a CCI ≥2, and the prevalence of diabetes, hyperlipidemia, and hypertension was 19%, 31%, and 62%, respectively. Among women with each cardiometabolic condition, the prevalence of medication use for diabetes, hypertension, and hyperlipidemia was 73%, 78%, and 60%. In bivariate analyses, women with a higher CCI, diabetes, hyperlipidemia, and hypertension had worse survival compared to women without these conditions (P&amp;lt;0.05). However, when adjusting for prognostic factors, only a high CCI (≥2 vs. 0) and diabetes were significantly associated with higher hazard of death (HR=1.36, 95% CI=1.06-1.74 and HR=1.40, 95% CI=1.08-1.81, respectively). Investigating the independent associations of each condition included in the CCI with survival revealed that diabetes was largely driving the association of CCI with survival. When considering medication use, women with diabetes, irrespective of medication use, women with hypertension not on medication, and women with hyperlipidemia on medication had worse survival compared to women without these conditions in bivariate models (P&amp;lt;0.05). Compared to women without diabetes, women with diabetes on medication and women with diabetes not on medication had a statistically significant higher hazard of death in multivariable models (HR=1.39, 95% CI=1.02-1.88 and HR=1.63, 95% CI=1.04-2.57, respectively). No associations with survival were observed when considering medication use for hypertension and hyperlipidemia after adjusting for prognostic factors. Conclusion: Similar to prior studies among White women with EOC, diabetes, regardless of medication status, was strongly associated with poorer survival among Black women with EOC. Citation Format: Alicia Richards, Courtney E. Johnson, Anthony J. Alberg, Elisa V. Bandera, Melissa Bondy, Michele L. Cote, Theresa A. Hastert, Kristen Haller, Jeffrey R. Marks, Edward S. Peters, Paul D. Terry, Andrew B. Lawson, Joellen M. Schildkraut, Lauren C. Peres. Pre-diagnostic comorbid conditions and survival among black women with ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4829.

Little is known about the burgeoning Mexican American (MA) population's pain experience. Using 1999-2004 National Health and Nutrition Examination Survey (NHANES) data, prevalence of chronic pain, analgesic medication use, and substance use were examined among MA, non-Hispanic White (NHW), and non-Hispanic Black (NHB) respondents. Logistic and linear regression models examined racial/ethnic differences in: 1) chronic pain prevalence among all respondents, 2) location and number of pain sites among respondents with chronic pain, and 3) analgesic medication and substance use among respondents with chronic pain. Compared to NHWs and NHBs, MAs were less likely to report any chronic pain. Among respondents with chronic pain, MAs had higher odds of reporting headache, abdominal pain, and a greater number of pain sites than NHWs. Compared to NHWs, MAs with chronic pain had lower odds of reporting past-month analgesic medication and COX-2 inhibitor use. MAs with chronic pain had lower odds of being a current cigarette smoker and heavy alcohol drinker but had similar street drug/cocaine use relative to NHWs. Results suggest that: 1) MAs are less likely to develop chronic pain than NHWs, 2) MAs with chronic pain report greater headache and abdominal pain than NHWs, and 3) MAs with chronic pain are less likely to use analgesic medications and other substances compared to NHWs. These results suggest that providers should consider taking extra time to discuss analgesic medications with MAs. Future investigations should examine reasons underlying these racial/ethnic differences in chronic pain, as well as differences in the use of other substances, such as marijuana.

Aim Given the rising trend of physical health problems reported by children and an increasing reliance on analgesic medications, this study aimed to describe the prevalence of physical health complaints and analgesic medication use in school-aged children aged 10–12 years. Additionally, associations with psychological and lifestyle factors were investigated. Subjects and methods A total of 99,806 children from Norway completed the Ungdata Junior survey between 2021 and 2022. This national standardized questionnaire-based survey contains questions measuring physical health, analgesic medication use, physical exercise, bullying, friendship, digital media use, and mental health. Multiple logistic regression analyses were conducted to investigate factors associated with daily physical health complaints and analgesic medication use. Results Of the children surveyed, 11.6% reported experiencing headaches, neck or shoulder pain, abdominal pain, and/or nausea on a daily basis during the past month. The prevalence of analgesic medication use during the past week was 23.6% for the entire sample and 25.9% for girls. Among the psychological and lifestyle factors investigated, mental health problems and being bullied were the strongest predictors of both physical health problems and analgesic medication use. Additionally, friendship, digital media use, and physical exercise also predicted physical health problems and analgesic medication use. Conclusion The study revealed a high prevalence of physical health complaints and analgesic medication use among children aged 9–12 years, highlighting significant associations with psychological and lifestyle factors. The findings suggest that children may rely on analgesic medications to manage not only physical pain but also emotional distress.

Background: The Ovarian Cancer in Women of African Ancestry consortium (OCWAA) was established to address racial disparities in epithelial ovarian cancer (EOC) risk and survival. Specifically, we aim to estimate the degrees to which racial differences in incidence and survival of EOC between African-American (AA) and white women are attributable to differences in the prevalence and timing of risk factors and in the magnitude of risk associations. Methods: OCWAA includes four case-control studies (the African-American Cancer Epidemiology Study, the North Carolina Ovarian Cancer Study, the Los Angeles County Ovarian Cancer Study, and the Cook County Case-Control Study) and two nested case-control studies within cohort studies (the Black Women's Health Study and the Multiethnic Cohort Study). A centralized core database consisting of demographic and epidemiologic risk factors for borderline and invasive EOC, tumor characteristics and prognostic factors has been created, and the majority of data has been harmonized across studies. A histotype classification scheme was uniformly applied using a combination of morphology and grade information to best represent the most recent diagnostic guidelines for ovarian cancer as detailed in the 2014 WHO Classification of Tumors of the Female Reproductive System. Results: A total of 1,169/2,324 AA cases and controls and 2,963/3,934 white cases and controls have been included in the OCWAA database to date. Approximately 83% of cases are invasive EOC, 15% are borderline tumors, and 2% are missing tumor behavior information. Among the invasive EOC cases, 61% are high-grade serous carcinomas. The average age at diagnosis of EOC cases is the same in AA and white women (57.2 years), and the year of diagnosis ranges from 1991 to 2016. The following risk factors showed marked prevalence differences in AA and white controls: obesity (46.3% vs 19.2%), breastfeeding (42.7% vs 54.3%), tubal ligation (31.1% vs 17.9%), postmenopausal hormone use (23.8% vs 40.8%), nulliparity (14.9% vs 19.2%), at least a college degree (35.5% vs 56.4%), and menarche age &amp;lt;13 (51.6% vs 47.4%; p&amp;lt;.01); p&amp;lt;.0001 for all except where noted. In preliminary EOC risk analyses, we observed positive associations with body mass index and nulliparity and inverse associations with tubal ligation, oral contraceptive use and breastfeeding in both AA and white women. The harmonization of other factors including duration, frequency and timing of key risk factors, physical activity, comorbidities, medication use, and treatment information is ongoing. Conclusions: OCWAA represents the largest study investigating disparities in ovarian cancer risk and survival between AA and white women. This consortium is uniquely positioned to study the epidemiology of ovarian cancer in AA, focusing on the role of lifestyle and behavioral characteristics, reproductive risk factors, treatment and other prognostic factors in explaining racial differences in ovarian cancer incidence and survival. This abstract is also being presented as Poster C083. Citation Format: Veronica Wendy Setiawan, Lauren Peres, Lynn Rosenberg, Traci Bethea, Patricia Moorman, Evan Myers, Anna Wu, Charlotte Joslin, Elisa Bandera, Deanna Chyn, Fabian Camacho, Joellen Schildkraut. Investigating the determinants of racial disparities in ovarian cancer incidence: The OCWAA consortium [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr PR16.

PurposeThe causes for the survival disparity among Black women with epithelial ovarian cancer (EOC) are likely multi-factorial. Here we describe the African American Cancer Epidemiology Study (AACES), the largest cohort of Black women with EOC.MethodsAACES phase 2 (enrolled 2020 onward) is a multi-site, population-based study focused on overall survival (OS) of EOC. Rapid case ascertainment is used in ongoing patient recruitment in eight U.S. states, both northern and southern. Data collection is composed of a survey, biospecimens, and medical record abstraction. Results characterizing the survival experience of the phase 1 study population (enrolled 2010–2015) are presented.ResultsThus far, ~ 650 patients with EOC have been enrolled in the AACES. The five-year OS of AACES participants approximates those of Black women in the Surveillance Epidemiology and End Results (SEER) registry who survive at least 10-month past diagnosis and is worse compared to white women in SEER, 49 vs. 60%, respectively. A high proportion of women in AACES have low levels of household income (45% < $25,000 annually), education (51% ≤ high school education), and insurance coverage (32% uninsured or Medicaid). Those followed annually differ from those without follow-up with higher levels of localized disease (28 vs 24%) and higher levels of optimal debulking status (73 vs 67%).ConclusionAACES is well positioned to evaluate the contribution of social determinants of health to the poor survival of Black women with EOC and advance understanding of the multi-factorial causes of the ovarian cancer survival disparity in Black women.

Exposure to natural sunlight has been associated with improvement in mood, reduced mortality among patients with cancer, and reduced length of hospitalization for patients who have experienced myocardial infarction. Our aim was to evaluate whether the amount of sunlight in a hospital room modifies a patient's psychosocial health, the quantity of analgesic medication used, and the pain medication cost. A prospective study of pain medication use was conducted in 89 patients undergoing elective cervical and lumbar spinal surgery where they were housed on either the "bright" or "dim" side of the same hospital unit. Analgesic medication was converted to standard morphine equivalents for interpatient comparison. The intensity of sunlight in each hospital room was measured daily and psychologic questionnaires were administered on the day after surgery and at discharge. Patients staying on the bright side of the hospital unit were exposed to 46% higher-intensity sunlight on average (p = .005). Patients exposed to an increased intensity of sunlight experienced less perceived stress (p = .035), marginally less pain (p = .058), took 22% less analgesic medication per hour (p = .047), and had 21% less pain medication costs (p = .047). Age quartile was the only other variable found to be a predictor of analgesic use, with a significant negative correlation (p <.001). However, patients housed on the bright side of the hospital consistently used less analgesic medications in all age quartiles. The exposure postoperatively of patients who have undergone spinal surgery to increased amounts of natural sunlight during their hospital recovery period may result in decreased stress, pain, analgesic medication use, and pain medication costs.

The current study examined the relationship between preoperative anxiety and acute postoperative phantom limb pain (PLP), residual limb pain (RLP), and analgesic medication use in a sample of persons undergoing lower limb amputation. Participants included 69 adults admitted to a large level 1 trauma hospital for lower limb amputation. Participants' average pain and anxiety during the previous week were assessed before amputation surgery. RLP, PLP, and analgesic medication use were measured on each of the 5 days following amputation surgery. Results of partial-order correlations indicated that greater preoperative anxiety was significantly associated with greater ratings of average PLP for each of the 5 days following amputation surgery, after controlling for preoperative pain ratings and daily postoperative analgesic medication use. Partial correlation values ranged from 0.30 to 0.62, indicating medium to large effects. Preoperative anxiety was also significantly associated with ratings of average RLP only on postoperative day 1, after controlling for preoperative pain ratings and daily postoperative analgesic medication use (r=0.34, P<0.05). Correlations between preoperative anxiety and daily postoperative analgesic medication dose became nonsignificant when controlling for preamputation and postamputation pain ratings. These findings suggest that anxiety may be a risk factor for acute postamputation PLP and RLP, and indicate that further research to examine these associations is warranted. If replicated, the findings would support research to examine the extent to which modifying preoperative anxiety yields a reduction in postoperative acute PLP and RLP.

BackgroundEach year nearly 300,000 women are diagnosed with ovarian cancer worldwide, and more than half of these women die within five years of their diagnosis. Clear evidence from epidemiological studies about factors affecting risk or survival is critical for efforts to prevent this cancer and improve prognosis. However, interpretation of findings has often been hampered by low sample sizes, biases in observational studies, and the historic practice of considering all ovarian cancers as one disease, although aetiological distinctions between the major histotypes are now recognised. Due partly to these limitations, it was unclear whether adiposity, greater height, or hysterectomy without oophorectomy are associated with ovarian cancer risk, and whether the use of common analgesic medications (aspirin and nonaspirin nonsteroidal anti-inflammatory drugs [NSAIDs], and acetaminophen) is associated with ovarian cancer survival. Each of these exposures affects a large, and growing, number of women globally.AimThe overall aim of this thesis was to address knowledge gaps in ovarian cancer epidemiology relating to several potential risk factors (adiposity, height, and hysterectomy) and exposures that may influence survival after diagnosis (common analgesic medications), using large complex datasets and non-traditional approaches.MethodsThe four studies included in this thesis each examined one exposure or several closely-related exposures in relation to ovarian cancer risk or survival, using two datasets and a variety of analytical methods. Two studies (examining adiposity and height in relation to ovarian cancer risk) applied Mendelian randomization (MR), a method which uses genetic variants as proxies for epidemiological exposures to overcome some of the biases that can affect observational research. Data were pooled from approximately 37,000 women (for adiposity analyses) or approximately 39,400 women (for height analyses) participating in 39 studies in the international Ovarian Cancer Association Consortium (OCAC). The third study used linked administrative data to follow approximately 840,000 Western Australian women over a 27-year period, and applied Cox proportional hazards regression with time-varying exposures and covariates to examine the association between hysterectomy and ovarian cancer risk. The final study used Cox proportional hazards regression to investigate the relationships between pre-diagnosis use of common analgesic medications and survival among approximately 7,700 women with ovarian cancer from 12 OCAC studies.ResultsThe first study used MR to show that greater adiposity increases risk (about a 30% increase in risk per five units of body mass index) of ovarian cancers other than high-grade serous, but not the common and aggressive high-grade serous cancers. Abdominal adiposity (waist-hip ratio) was not associated with risk of either high-grade serous or non-high grade serous ovarian cancers. The second study indicated that greater height is associated with increased risk of invasive (a 6% increase in risk per five centimetres) and borderline (15% risk increase) ovarian cancers, and that risk is most elevated for clear cell cancers (20% risk increase). In the third study, hysterectomy was not associated with risk of invasive ovarian cancer overall or with the common serous cancers, although there was a suggestion of reduced risk of the rarer histotypes (mucinous, endometrioid, and clear cell cancers). For women with endometriosis or uterine fibroids, hysterectomy was associated with a markedly decreased risk of ovarian cancer (about 85% and 75% decreases in overall risk, respectively). Results of the fourth study indicated that use of aspirin, nonaspirin NSAIDs, or acetaminophen before diagnosis of ovarian cancer is unlikely to substantially affect survival.ConclusionsThis thesis contributed new evidence on the relevance of several factors to ovarian cancer risk and survival. The finding that adiposity increases risk of non-high grade serous ovarian cancers, but not high-grade serous cancers, adds to growing evidence on the health benefits of avoiding overweight, but suggests that obesity prevention will not reduce incidence of the histotype responsible for most ovarian cancer deaths. The finding that pathways determining stature are important for ovarian carcinogenesis suggests avenues for future prevention research, for instance continued investigation of growth hormones. The results of the third study suggested that most women should continue to be vigilant for ovarian cancer symptoms after hysterectomy with conservation of ovaries. Future research is needed to confirm the protective association for hysterectomy among women with endometriosis or fibroids before this evidence can be considered in treatment decisions. The finding that pre-diagnosis use of common analgesic medications has minimal effect, if any, on ovarian cancer survival is useful to reassure women at diagnosis about past use of these medications, but future studies with large samples and post-diagnosis exposure data should continue to investigate this relationship. Overall, the evidence from this thesis will contribute to helping public health practitioners, policymakers, clinicians, and researchers better understand the epidemiological relationships covered by this research, communicate these accurately to women at risk, and act on these exposures where possible to reduce population burden from this cancer.

Cardiometabolic comorbidities and epithelial ovarian cancer risk among African-American women in the African-American Cancer Epidemiology Study (AACES)

Objective: Obesity disproportionately affects African American (AA) women, and there is some suggestion that its association with ovarian cancer risk may be stronger among AA compared to white women, but no study to date has been adequately powered to compare risk between the two populations. The Ovarian Cancer in Women of African Ancestry (OCWAA) Consortium provided a unique opportunity to evaluate the association between body mass index (BMI) and invasive epithelial ovarian cancer (EOC) risk in AA and white women and to estimate the contribution of obesity to ovarian cancer risk in both racial groups. Methods: The OCWAA Consortium is a collaboration of six of the largest epidemiologic studies of ovarian cancer in the United States that include AA women: four case-control and two case-control studies nested within cohort studies. The six studies are the Chicago Case-Control Study, the North Carolina Ovarian Cancer Study, the Los Angeles Ovarian Cancer Case-Control Studies, the African American Cancer Epidemiology Study, the Black Women’s Health Study, and the Multiethnic Cohort. BMI before diagnosis was available in all the studies and data on BMI and relevant confounders were harmonized for analyses. There were 1,144 AA cases, 2,910 AA controls, 3,174 white cases, and 9,160 white controls included. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed using random-effects multi-level logistic regression models separately by race and histotype with control for relevant covariates, which included study, age, education, parity, oral contraceptive use, age at menarche and family history of breast/ovarian cancer. Multinomial regression was used for histotype analyses. Population attributable risk (PAR) estimates were computed by race and histotype. Results: The prevalence of obesity (BMI≥30 kg/m2) was higher in AAs compared to white women for both cases (53.2% vs 21.4%) and controls (45.7% vs. 18.4%). For EOC, there was little evidence of an association with obesity for white women. For AAs, risk was elevated for BMI≥30 kg/m2 (ORBMI 30-34=1.37, 95% CI: 1.12, 1.69; ORBMI≥35 = 1.26, 95% CI: 0.74, 2.15) relative to BMI 18.5-&amp;lt;25 kg/m2. There was an elevated risk for non-high-grade serous EOC for both AA and white women (for AA women, ORBMI 30-34=1.67, 95% CI: 1.14, 2.44 and ORBMI≥35 = 1.76; 95% CI: 0.84, 3.69; for white women, ORBMI ≥35 = 1.39; 95% CI: 1.06, 1.82), but not for high-grade serous EOC. The PAR for BMI≥30 was 7.1% (95% CI: 2.4, 15.6) for AAs and 2.6% (95% CI: -0.3, 5.4) for whites for all EOC. For non-high-grade serous EOC, the PAR was 16.5% (95% CI: 3.4, 28.2) for AAs and 6.4% (95% CI: 2.2, 10.3) for whites. Conclusions: Obesity was a contributor to overall EOC risk among AA women but not among white women. Obesity did not contribute to the risk of high-grade serous EOC for AAs or whites, but it was associated with non-high-grade serous cases among both AA and white women. The association with non-high-grade serous EOC was greater among AAs than whites. Citation Format: Elisa V Bandera, Fabian Camacho, Deanna Chyn, Emily K Cloyd, Traci N Bethea, Alicia Beeghly-Fadiel, Charlotte E Joslin, Evan Myers, Patricia G Moorman, Heather M Ochs-Balcom, Holly R Harris, Lauren C Peres, Veronica Wendy Setiawan, Anna H Wu, Lynn Rosenberg, Joellen M Schildkraut. Racial disparities in body mass index and ovarian cancer risk in the OCWAA Consortium [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C070.

A Randomized Controlled Trial of Music for Pain Relief after Arthroplasty Surgery

Background: The incidence of epithelial ovarian cancer (EOC) is lower among African-American (AA) women compared to European American (EA) women (9.8 vs. 13.0 cases/100,000), but AA women have markedly worse outcomes. The purpose of this study is to describe the health-related quality of life (HRQL) in AA women with EOC and its correlates using data from a multisite population-based case-control study of invasive EOC in AA women, the African American Cancer Epidemiology Study (AACES). Methods: 215 cases completed a first annual follow-up questionnaire, including the HRQL and psychosocial surveys &amp;lt;18 months post diagnosis. The primary HRQL outcome was assessed with SF-8 component scores for physical (PCS) and mental (MCS) health. Correlates examined were patient, disease and treatment characteristics, modified Charlson index, perceived social support, perceived discrimination, leisure-time physical activity, the Life Orientation Test (LOTR), and phobic anxiety (Crown-Crisp Inventory, CCI-PA). Ordinary least squares regression was used to estimate linear trend effects for all predictors adjusting for age at diagnosis, comorbidity, BMI, stage and income. Results: Higher household family income, lower phobic anxiety, higher social support, and higher leisure physical activity levels were associated with higher MCS and PCS (p &amp;lt; 0.01). Higher perceived discrimination was associated with both lower MCS and PCS, while higher optimism (LOTR) was associated with higher MCS. In multivariable analyses including all predictors, CCI-PA and LOTR remained significant predictors of MCS (p &amp;lt; 0.01), and BMI, phobic anxiety, and social support predicted PCS (p &amp;lt; 0.001). Conclusion: Prediagnosis characteristics and exposures of AA women with EOC are important predictors of HRQL after cancer diagnosis, and in AACES were more important than tumor characteristics. Cancer survivorship programs that enhance patients' social support and physical activity could have important benefits by reducing emotional distress and increasing perceived vitality. Citation Format: Roger T. Anderson, Fabian Camacho, Elisa Bandera, Ellen Funkhouser, Patricia Moorman, Lisa Paddock, Lauren C. Peres, Edward Peters, Sarah E. Abbott, Anthony J. Alberg, Jill Barnholtz-Sloan, Melissa Bondy, Michele L. Cote, Ann Schwartz, Paul Terry, Joellen Schildkraut. Correlates of health-related quality of life among African-American survivors of ovarian cancer: Results from the AACES Study [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C42.