歧视可能会对健康产生不利影响并加速衰老，但关于这些关系在癌症幸存者中的情况仍知之甚少。该研究考察了自我认同为非洲裔美国幸存者的歧视与衰老的关联。在2017年至2022年之间，对诊断时年龄在20-79岁的2232名癌症幸存者进行了人群样本调查，包括787名乳腺癌、227名结肠癌、223名肺癌和995名前列腺癌患者。在完成了主动治疗后填写了调查表。缺陷累积指数评估了与衰老有关的疾病和功能（得分范围为0-1，其中<0.20是强健的，0.20至<0.35是前弱的，0.35+是脆弱的；0.06是具有临床意义的大差异）。歧视量表评估了所有经历过的重大歧视以及七种类型的事件（得分为0-7）。线性回归分析了歧视与缺陷累积之间的关系，控制了年龄、诊断时间、癌症类型、阶段和治疗，以及社会人口学变量。幸存者平均年龄为62岁（标准差为9.6岁），63.2%报告曾经历过重大歧视，平均遭受了2.4（标准差为1.7）种歧视事件。只有24.4%的人具有被视为强健的缺陷累积得分（平均得分为0.30 [标准差为0.13]）。在那些报告曾经历过重大歧视的人群中，与接受0-1种歧视事件的幸存者相比，遭受4-7种歧视事件的人会有一个具有临床意义的大幅增加（0.062，p < 0.001），而这种趋势在各种癌症类型中都是一致的。非洲裔美国癌症幸存者的缺陷累积指数得分高，重大歧视经历与这些缺陷呈正相关。未来需要进行更多的研究来了解不同人群中衰老、歧视和癌症幸存之间的交叉因素。

Discrimination can adversely affect health and accelerate aging, but little is known about these relationships in cancer survivors. This study examines associations of discrimination and aging among self-identified African American survivors.A population-based sample of 2232 survivors 20-79 years old at diagnosis were enrolled within 5 years of breast (n = 787), colorectal (n = 227), lung (n = 223), or prostate (n = 995) cancer between 2017 and 2022. Surveys were completed post-active therapy. A deficit accumulation index measured aging-related disease and function (score range, 0-1, where <0.20 is robust, 0.20 to <0.35 is pre-frail, and 0.35+ is frail; 0.06 is a large clinically meaningful difference). The discrimination scale assessed ever experiencing major discrimination and seven types of events (score, 0-7). Linear regression tested the association of discrimination and deficit accumulation, controlling for age, time from diagnosis, cancer type, stage and therapy, and sociodemographic variables.Survivors were an average of 62 years old (SD, 9.6), 63.2% reported ever experiencing major discrimination, with an average of 2.4 (SD, 1.7) types of discrimination events. Only 24.4% had deficit accumulation scores considered robust (mean score, 0.30 [SD, 0.13]). Among those who reported ever experiencing major discrimination, survivors with four to seven types of discrimination events (vs. 0-1) had a large, clinically meaningful increase in adjusted deficits (0.062, p < .001) and this pattern was consistent across cancer types.African American cancer survivors have high deficit accumulated index scores, and experiences of major discrimination were positively associated with these deficits. Future studies are needed to understand the intersectionality between aging, discrimination, and cancer survivorship among diverse populations.© 2023 American Cancer Society.