Age-specific detriments to quality of life among breast cancer patients one year after diagnosis
Introduction
Cancer of the breast is the most frequent malignant tumour among women and accounts for more than 1 000 000 new cases worldwide each year [1]. Breast cancer survivors represent the largest group of long-term cancer survivors. They comprise approximately 40% of all female cancer survivors in developed countries [2], and it can be expected that this number will increase over the next few decades due the demographic age-shift with populations living for longer and due to further advances made in breast cancer therapy.
Beside disease-free and overall survival time, quality of life (QOL) is a decisive outcome measure for cancer patients. The term QOL refers to a multidimensional concept which includes at least the dimensions physical, emotional and social functioning. QOL has become an important outcome measure in the treatment of cancer patients during the last decade and has been assessed in many clinical trials to evaluate the effects of specific therapies. In contrast, only a few studies have compared breast cancer survivors with non-cancer patients in order to identify the specific needs of these women 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15. In general, older people reported worse quality of life and worse physical functioning, but better emotional functioning, than younger people. However, the interpretation of these studies may be limited, as many of these studies were based on selective samples of patients from one or few hospitals 4, 5, 6, 7, 8, 9, 10, 11 or included women with a wide range of survival times 8, 13.
The objective of this study was to describe the QOL of patients with breast cancer one year after their diagnosis from a large population-based cohort. At this time, it could be expected that the acute treatment effects would have declined and our aim was to identify any differences in the QOL of breast cancer survivors in comparison with women from the general population.
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Study design
This analysis is based on data obtained from the Verlauf der diagnostischen Abklärung bei Krebserkrankungen (VERDI)-study, a population-based state-wide prospective cohort study on risk factors, diagnostic procedures and prognosis for various forms of cancer in Saarland (a state in Southwest Germany covering a population of approximately 1 million inhabitants) 16, 17, 18. Potential study participants were identified by their clinicians during their first hospitalisation. With the exception of
Characteristics of the study population
Baseline characteristics of the breast cancer patients according to their vital status and follow-up are shown in Table 1. The mean age at diagnosis was 58 years (age range 30–80 years). The level of education in our study sample was relatively low. Only one quarter of all breast cancer patients completed 10 years or more of schooling in contrast to approximately 34% of reference population after correction for differences in the age distribution. However, no differences were observed between
Discussion
QOL has become an important outcome measure in the treatment of cancer patients and the specific needs of cancer survivors deserve more attention. Our results suggest that overall QOL/global health and physical functioning of breast cancer patients is comparable to women from the general population one year after the diagnosis of breast cancer when most acute treatment-related effects should have disappeared. In contrast, deficits in emotional, social, role, and cognitive functioning are still
Conflict of interest statement
There is no conflict of interest for any author of this study. There are no financial or other relationships that might bias the work or interfere with our objective judgement(s).
Acknowledgements
This study was supported by the German Cancer Foundation (Deutsche Krebshilfe), Project Number 70-2413-Br 3 I.
References (32)
- et al.
Psychosocial adjustment and quality of life in women with breast cancer and benign breast problemsa controlled comparison
J. Clin. Epidemiol.
(1996) - et al.
Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population
Eur. J. Cancer
(2001) - et al.
GLOBOCAN 2000: Cancer Incidence, Mortality and Prevalence Worldwide, Version 1.0. IARC CancerBase No. 5
(2001) - Office on Cancer Survivorship. Cancer Survivorship Research, National Cancer Institute, Division of Cancer Control and...
- et al.
Long-term quality of life after breast cancercomparison of 8-year survivors with population controls
J. Clin. Oncol.
(1998) - et al.
Physical and psychosocial functioning and adjustment to breast cancer. Long-term follow-up of a screening population
Cancer
(1989) - et al.
Subclinical psychological distress in long-term survivors of breast cancera preliminary communication
J. Psychosoc. Oncol.
(1996) - et al.
Relationship between quality of life and mood in long-term survivors of breast cancer treated with mastectomy
Support Care Cancer
(1997) - et al.
The impact of diagnosis and treatment on the quality of life in breast cancer patients
Neoplasma
(1998) - et al.
A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer
Ann. Oncol.
(2000)
Five years latera cross-sectional comparison of breast cancer survivors with healthy women
Psychooncology
Psychometric assessment of the Life Satisfaction Questionnaire (LSQ) and a comparison of a randomised sample of Swedish women and those suffering from breast cancer
Qual. Life Res.
Breast cancer survivorspsychosocial concerns and quality of life
Breast Cancer Res. Treat.
Life after breast cancerunderstanding women's health-related quality of life and sexual functioning
J. Clin. Oncol.
Quality of life in breast and colon cancer long-term survivorsan assessment with the EORTC QLQ-C30 and SF-36 questionnaires
Tumori
Psychological response to mastectomy. A prospective comparison study
Cancer
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VA and HM contributed equally to the manuscript.