Cancer
Acculturation, fatigue, and stress in Hispanic/Latino colorectal cancer survivors Nicole C. Lorona* Nicole Lorona Stephanie L. Schmit Jane C. Figueiredo
Background: Acculturation is associated with poorer psychosocial health and greater colorectal cancer (CRC) burden in the Hispanic/Latino population. We examined the effect of acculturation on fatigue and stress in Hispanic/Latino CRC survivors.
Methods: The present study included 964 men and women aged 21 and older, self-identifying as Hispanic, and newly diagnosed with CRC in Los Angeles, California, beginning in 2008. Validated measures of fatigue and stress were collected using English and Spanish versions of the Multidimensional Fatigue Symptom Inventory–Short Form (MFSI) and the short Depression Anxiety Stress Scales (DASS-21). Items from each measure were summed to create discrete summary scores and were further categorized into quartiles. We fit ordinal logistic regression models to quantify the association between proxies of acculturation (language preference and US/foreign-born status) and fatigue and stress scores. We fit multinomial logistic regression models to examine the associations for score quartiles.
Results: Participants whose preferred language was Spanish had a higher median age at diagnosis, were more likely to have rectal tumors, and were less likely to smoke cigarettes or drink alcohol. Adjusting for age, sex, body mass index, alcohol, smoking, education, and work-related physical activity, Spanish language preference was associated with lower fatigue scores (OR:0.63; 95%CI:0.47-0.83) and lower stress scores (OR:0.82; 95%CI:0.62-1.09). Most notably, Spanish speakers had 56% lower odds of being in the highest quartile of fatigue score (95%CI:0.28-0.73) than English speakers. Foreign country of birth was associated with lower fatigue (OR:0.78; 95%CI:0.60-1.03), but not stress scores (OR:0.97; 95%CI:0.74-1.27).
Conclusions: Hispanic/Latino CRC survivors with higher levels of acculturation report higher levels of fatigue and stress post-diagnosis.