424Person-centred outcomes among 22,205 cancer survivors and 244,000 people without cancer: a population-based Australian study

Abstract Background With the majority of people with cancer surviving long-term, holistic consideration of health and wellbeing outcomes is critical to optimise survivorship. We quantified short- and long-term physical and mental health-related outcomes in people with and without cancer, including according to cancer type and clinical characteristics. Methods 45 and Up Study (n = 267,153) baseline survey data (2006-2009) were linked to cancer registrations (by the Centre for Health Record Linkage) and cancer diagnoses up to enrolment identified. Modified Poisson regression estimated age-and-sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes - severe physical functioning limitations, moderate/high psychological distress and fair/poor quality of life - in participants with versus without cancer. Results Cancer survivors (n = 22,205) had significantly higher prevalence of physical functioning limitations compared to participants without cancer (21% versus 13%) PR = 1.28(95%CI=1.25-1.32), overall and in all population subgroups examined. Corresponding estimates were 22% versus 24% (1.05(1.02-1.08)) for psychological distress and 15% versus 10% (1.28(1.24-1.32) for fair/poor quality of life. Outcomes varied by cancer type, being worse for multiple myeloma, lung cancer and non-Hodgkin’s lymphoma; worse outcomes were also associated with recent diagnosis, recent treatment and advanced stage. Physical functioning limitations in cancer survivors were major contributors to adverse distress and quality of life outcomes. Conclusions Cancer survivors experience adverse physical and mental health outcomes; substantial parts of elevated distress and poor quality of life are likely attributable to physical disability. Key messages In addition to routine screening for psychological distress, management of physical disability and other symptoms are important to optimise cancer survivorship.

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Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer

BMC Medicine ◽

10.1186/s12916-020-01830-4 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Grace Joshy ◽

Joanne Thandrayen ◽

Bogda Koczwara ◽

Phyllis Butow ◽

Rebekah Laidsaar-Powell ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Cancer Survivors ◽

Physical Disability ◽

Functional Limitations ◽

Population Based ◽

Cancer Registration ◽

Cancer Type ◽

Physical And Mental Health

Abstract Background Improved survival means that cancer is increasingly becoming a chronic disease. Understanding and improving functional outcomes are critical to optimising survivorship. We quantified physical and mental health-related outcomes in people with versus without cancer, according to cancer type. Methods Questionnaire data from an Australian population-based cohort study (45 and Up Study (n = 267,153)) were linked to cancer registration data to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes—severe physical functional limitations (disability), moderate/high psychological distress and fair/poor quality of life (QoL)—in participants with versus without cancer, for 13 cancer types. Results Compared to participants without cancer (n = 244,000), cancer survivors (n = 22,505) had greater disability (20.6% versus 12.6%, respectively, PR = 1.28, 95%CI = (1.25–1.32)), psychological (22.2% versus 23.5%, 1.05 (1.02–1.08)) and poor/fair QoL (15.2% versus 10.2%; 1.28 (1.24–1.32)). The outcomes varied by cancer type, being worse for multiple myeloma (PRs versus participants without cancer for disability 3.10, 2.56–3.77; distress 1.53, 1.20–1.96; poor/fair QoL 2.40, 1.87–3.07), lung cancer (disability 2.81, 2.50–3.15; distress 1.67, 1.46–1.92; poor/fair QoL 2.53, 2.21–2.91) and non-Hodgkin’s lymphoma (disability 1.56, 1.37–1.78; distress 1.20, 1.05–1.36; poor/fair QoL 1.66, 1.44–1.92) and closer to those in people without cancer for breast cancer (disability 1.23, 1.16–1.32; distress 0.95, 0.90–1.01; poor/fair QoL 1.15, 1.05–1.25), prostate cancer (disability 1.11, 1.04–1.19; distress 1.09, 1.02–1.15; poor/fair QoL 1.15, 1.08–1.23) and melanoma (disability 1.02, 0.94–1.10; distress 0.96, 0.89–1.03; poor/fair QoL 0.92, 0.83–1.01). Outcomes were worse with recent diagnosis and treatment and advanced stage. Physical disability in cancer survivors was greater in all population subgroups examined and was a major contributor to adverse distress and QoL outcomes. Conclusions Physical disability, distress and reduced QoL are common after cancer and vary according to cancer type suggesting priority areas for research, and care and support.

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Quality of Life in Ovarian Cancer Survivors: The Influence of Obesity

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000388 ◽

2015 ◽

Vol 25 (4) ◽

pp. 616-621 ◽

Cited By ~ 14

Author(s):

Anke Smits ◽

Alberto Lopes ◽

Nagindra Das ◽

Ruud Bekkers ◽

Khadra Galaal

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Cancer Survivors ◽

Multiple Regression ◽

Physical Functioning ◽

Emotional Functioning ◽

Life Questionnaire ◽

Life Outcomes ◽

Quality Of Life Outcomes

ObjectiveIn this study, we evaluated the effect of body mass index (BMI) on the quality of life of ovarian cancer survivors.MethodsWomen diagnosed with ovarian cancer at the Royal Cornwall Hospital Trust between January 2008 and May 2013 were identified. Ovarian cancer survivors were invited to participate by completing the European Organization for Research and Treatment of Cancer QLQ-C30 (quality of life) questionnaire. Univariate and multiple regression analyses were used to determine associations between BMI and quality-of-life outcomes.ResultsA total of 176 ovarian cancer survivors were invited to participate, of which 133 were eligible for this study. In total, 81 ovarian cancer survivors (60.4%) completed the questionnaire, of which 26 responders (32.1%) were overweight (BMI, 25–29.9 kg/m2) and 27 (33.3%) were obese (BMI, ≥30 kg/m2). Increasing BMI was significantly associated with poorer quality-of-life outcomes in terms of physical functioning and emotional functioning, and this effect persisted for physical functioning after multiple regression analysis.ConclusionsIncreasing BMI is associated with poorer quality-of-life outcomes in terms of physical and emotional functioning in ovarian cancer survivors. Further research is needed to evaluate the association between BMI and quality of life from diagnosis to survivorship to develop novel interventions.

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Faculty Opinions recommendation of Factors associated with poor quality of life among cervical cancer survivors: implications for clinical care and clinical trials.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718634930.793502075 ◽

2014 ◽

Author(s):

David Kushner ◽

Laura Huffman

Keyword(s):

Quality Of Life ◽

Cervical Cancer ◽

Clinical Trials ◽

Cancer Survivors ◽

Clinical Care ◽

Poor Quality ◽

Factors Associated

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Quality of life and psychological distress in cancer survivors: The role of psycho‐social resources for resilience

Psycho-Oncology ◽

10.1002/pon.4934 ◽

2018 ◽

Vol 28 (2) ◽

pp. 271-277 ◽

Cited By ~ 11

Author(s):

Craig A. Harms ◽

Lynne Cohen ◽

Julie Ann Pooley ◽

Suzanne K. Chambers ◽

Daniel A. Galvão ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Cancer Survivors ◽

Social Resources

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Impacts of Psychological Distress, Gender Role Attitude, and Housekeeping Sharing on Quality of Life of Gynecologic Cancer Survivors

Korean Journal of Women Health Nursing ◽

10.4069/kjwhn.2018.24.3.287 ◽

2018 ◽

Vol 24 (3) ◽

pp. 287

Author(s):

Gunhee Kim ◽

Moonjeong Kim

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Gender Role ◽

Cancer Survivors ◽

Gynecologic Cancer ◽

Gender Role Attitude

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Symptom burden, psychological distress, and health-related quality of life in cancer survivors with pelvic late radiation tissue injuries

Supportive Care in Cancer ◽

10.1007/s00520-021-06684-x ◽

2021 ◽

Author(s):

Grete K. Velure ◽

Bernd Müller ◽

May Aa. Hauken

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Cancer Survivors ◽

Symptom Burden ◽

Life Questionnaire ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Tissue Injuries

Abstract Purpose Curative radiotherapy for cancer may lead to severe late radiation tissue injuries (LRTIs). However, limited knowledge exists about pelvic cancer survivors’ LRTI symptoms, distress, and health-related quality of life (HRQOL). We sought to assess the symptom burden, distress, and HRQOL in survivors with established pelvic LRTIs compared to norm populations and to investigate the relation between these factors. Methods Cancer survivors referred for treatment of established pelvic LRTIs were recruited nationwide. LTRIs were assessed with the Expanded Prostate Cancer Index Composite (EPIC), psychological distress was assessed with the General Health Questionnaire (GHQ-12), and HRQOL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORCT-QLQ-C30). Results A total of 107 participants (mean age 64, 53% men) were included. Compared to norms, participants reported more urinary (mean 68.7 vs. 89.5; p = 0.00; d = 1.4) and bowel symptoms (mean 62.5 vs. 92.4; p = 0.00; d = 2.7), increased psychological distress (mean 13.4 vs. 10.3; p = 0.00; d = 0.6), and overall poorer HRQOL (mean 54.9 vs. 71.2; p = 0.00; d = 0.7). Higher symptom burden and higher levels of psychological distress were associated with lower HRQOL (r2 = 46%), but psychological distress did not moderate the influence of symptoms on HRQOL. Conclusion Cancer survivors with established pelvic LRTIs are highly burdened compared to norms. The association of the LRTI-related symptom burden with HRQOL is independent of the level of psychological distress. Both coping and treatment interventions are crucial to promoting long-term health and HRQOL. Trial registration NCT03570229.

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Long-term employment status and quality of life after cancer: A longitudinal prospective cohort study from diagnosis up to and including 5 years post diagnosis

Work ◽

10.3233/wor-203234 ◽

2020 ◽

Vol 66 (4) ◽

pp. 901-907

Author(s):

Sietske J. Tamminga ◽

Lyanne P. Jansen ◽

Monique H.W. Frings-Dresen ◽

Angela G.E.M. de Boer

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Employment Status ◽

Life Outcomes ◽

Quality Of Life Outcomes ◽

Multi Level ◽

After Cancer ◽

Level Analysis

BACKGROUND: Accumulating evidence suggests that cancer survivors are able to return to work. However, little is known about their work situation 5 years after diagnosis. OBJECTIVE: To explore fluctuations in employment status and its association with quality of life 2, 3, and 5 years after cancer diagnosis of 65 cancer survivors employed at diagnosis. METHODS: In association with a randomised controlled trial (RCT), questionnaires were administrated to eligible cancer survivors at diagnosis, 2, 3, and 5 years thereafter comprising of validated questionnaires related to work (i.e. Work Ability Index (WAI), cancer, and quality of life (QOL) (i.e. SF-36, VAS QOL). The RCT studied a hospital-based work support intervention in female breast and gynaecological cancer survivors who were treated with curative intent and had paid work at diagnosis. Descriptive statistics and longitudinal multi-level analysis were employed. RESULTS: Sixty-five of the 102 eligible cancer survivors participated, who were primarily diagnosed with breast cancer (63%). Two and 5 years after cancer diagnosis respectively 63 (97%) and 48 (81%) participants were employed. Reasons for not being employed after 5 years included receiving unemployment benefits (7%), voluntary unemployment (3%), receiving disability benefits (3%), and early retirement (3%). Longitudinal multi-level analysis showed that employed cancer survivors reported in general statistically significant better quality of life outcomes at 5 years follow-up compared to those not being employed. CONCLUSIONS: We found high employment rates and few fluctuations in employment status. The steepest decline in employment rate occurs after the first two years of diagnosis. Employed participants reported better quality of life outcomes. Survivorship care should therefore focus on the population at risk possibly within the first two years after diagnosis.

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Predictors of Quality of Life in Young Adults Diagnosed With Cancer

Clinical Nursing Research ◽

10.1177/1054773820928197 ◽

2020 ◽

Vol 29 (8) ◽

pp. 587-597

Author(s):

Charmaine A. McKie ◽

Adeyinka O. Laiyemo

Keyword(s):

Quality Of Life ◽

Young Adults ◽

Health Status ◽

Cancer Survivors ◽

Functional Status ◽

Cancer Type ◽

Health Related ◽

Perception Of Health ◽

The Impact

A cross-section correlational study was conducted to evaluate the overall quality of life in young adults (AYAs) diagnosed with cancer, and the impact of health-related and non-health-related factors on their quality of life. Fifty-six AYA cancer survivors were recruited to elicit the impact of biological function (cancer type and comorbidity), symptoms, functional status, general perception of health status, gender, and characteristics of the environment on quality of life. Participants experienced higher than average quality of life. Symptoms, functional status, and general perception of health status were significant predictors of quality of life in this group of AYAs diagnosed with cancer. In delivering quality cancer care, nurses must be able to thoroughly assess symptom status, AYA cancer survivors’ perception of their health status, and functioning in order to implement supportive measures to help improve their quality of life.

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