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Journal of Cancer Epidemiology
Volume 2012, Article ID 478642, 9 pages
Clinical Study

Double Jeopardy? Age, Race, and HRQOL in Older Adults with Cancer

1Department of Human Development and Family Studies, University of Connecticut Storrs, CT 06269, USA
2Division of Cancer Control Population Sciences, National Cancer Institute, Rockville, MD 20852, USA
3Department of Social Sciences Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27104-4225, USA
4Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90089, USA
5Cancer Prevention Institute of California, Fremont, CA 94538, USA
6Information Management Services, Silver Spring, MD 20904, USA

Received 22 March 2012; Accepted 29 May 2012

Academic Editor: Marjan van den Akker

Copyright © 2012 Keith M. Bellizzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Understanding the post-treatment physical and mental function of older adults from ethnic/racial minority backgrounds with cancer is a critical step to determine the services required to serve this growing population. The double jeopardy hypothesis suggests being a minority and old could have compounding effects on health. This population-based study examined the physical and mental function of older adults by age (mean age = 75.7, SD = 6.1), ethnicity/race, and cancer (breast, prostate, colorectal, and gynecologic) as well as interaction effects between age, ethnicity/race and HRQOL. There was evidence of a significant age by ethnicity/race interaction in physical function for breast, prostate and all sites combined, but the interaction became non-significant (for breast and all sites combined) when comorbidity was entered into the model. The interaction persisted in the prostate cancer group after controlling for comorbidity, such that African Americans and Asian Americans in the 75–79 age group report lower physical health than non-Hispanic Whites and Hispanic Whites in this age group. The presence of double jeopardy in the breast and all sites combined group can be explained by a differential comorbid burden among the older (75–79) minority group, but the interaction found in prostate cancer survivors does not reflect this differential comorbid burden.