ArticleJournal of cancer survivorship : research and practice2025
Perceived discrimination, patient-provider communication, and quality of life among breast cancer survivors: a mediation analysis.
Article in Journal of cancer survivorship : research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeBreast cancer is common among women in the US and can impact survivors' quality of life (QoL). Perceived discrimination, defined as unfair treatment based on group membership, is often associated with poorer QoL, while effective patient-provider communication is often linked to better QoL. However, whether communication can mitigate the negative effects of discrimination remains unclear. This study investigates the relationship between perceived discrimination and QoL among women with early-stage breast cancer, and the potential mediating role of patient-provider communication.
methodsWe analyzed baseline survey data from women with early-stage breast cancer enrolled in a randomized control trial. Validated instruments were used to measure perceived discrimination, patient-provider communication, and mental and physical QoL. We used linear regression to assess the association between discrimination and outcomes (QoL and patient-provider communication), and mediation analysis to evaluate if patient-provider communication mediated the relationship between discrimination and QoL.
resultsAmong 303 women surveyed, 35.6% reported experiencing discrimination at least yearly. Experiencing discrimination at least yearly was significantly associated with worse patient-provider communication, mental health QoL, and physical health QoL (p-values < 0.05). No significant mediating effect of patient-provider communication was observed in the discrimination-QoL relationships.
conclusionsPerceived discrimination and patient-provider communication are both independently associated with QoL, however, patient-provider communication does not mediate the relationship between discrimination and QoL. IMPLICATIONS FOR CANCER SURVIVORS: Perceived discrimination and patient-provider communication play distinct roles in breast cancer survivors' QoL. Improving the quality of life for cancer survivors requires addressing upstream sources of discrimination and bias, including structural racism.
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