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

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

International Journal of Epidemiology ◽

10.1093/ije/dyab168.328 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Grace Joshy ◽

Joanne Thandrayen ◽

Bogda Koczwara ◽

Phyllis Butow ◽

Rebekah Laidsaar-Powell ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Cancer Survivors ◽

Physical Functioning ◽

Poor Quality ◽

Cancer Type ◽

Life Outcomes ◽

Physical And Mental Health ◽

Fair Poor

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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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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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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