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Survivors of some cancers face tougher challenges

Tuesday October 30, 2012
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Although survivors of many common cancers enjoy a mental and physical health-related quality of life equal to that of adults who have not had cancer, survivors of other cancers are in poorer health, according to a study.

"We did not have a good sense of how cancer survivors across the United States were faring after their cancer diagnosis and immediate treatment," Kathryn E. Weaver, PhD, MPH, assistant professor at Wake Forest Baptist Medical Center in Winston-Salem, N.C., said in a news release. "We set out to address this issue by estimating the number and percent of cancer survivors in the United States with poor physical and mental health and compared them to adults who have never had a cancer diagnosis."

Weaver and researchers from the National Cancer Institute and the Centers for Disease Control and Prevention analyzed data from the 2010 National Health Interview Survey, a large survey conducted by the CDC to track trends in illness and disability in the United States. They identified a cohort of 1,822 cancer survivors and compared them with 24,804 adults with no history of cancer.

Patient-reported, health-related quality of life was assessed using the 10-item Patient-Reported Outcomes Measurement Information System Global Health Scale. This tool allows researchers to measure, from the patientís perspective, health outcomes such as physical functioning, depression, pain and fatigue.

After adjusting for gender, race/ethnicity, education and other medical conditions, the researchers found that survivors of breast cancer, prostate cancer and melanoma had a health-related quality of life equivalent to or better than adults with no cancer history.

In contrast, survivors of cervical, blood and colorectal cancers, as well as survivors of cancers with a five-year survival rate of less than 25% (such as cancers of the liver, lung and pancreas), had worse physical health-related quality of life. In addition, survivors of cervical cancer and cancers with a low five-year survival rate had worse mental health-related quality of life.

Of cancer survivors in the analytic sample, 25% and 10% had below-average physical and mental health-related quality of life, respectively. The researchers thus estimated that 3.3 million cancer survivors in the United States have below-average physical health-related quality of life and almost 1.4 million have below-average mental health-related quality of life.

"It is very concerning that there are a substantial number of cancer survivors who experience poor mental or physical health years after cancer," Weaver said. "Our results will serve as a baseline so that in five to 10 years, we can assess whether current approaches to improving the health and well-being of cancer survivors are having a positive effect.

"I also hope our data will draw attention to the ongoing needs of cancer survivors — particularly those with cervical, blood and less common cancers — and to the importance of monitoring these individuals, even long after their cancer diagnosis."

The study appeared Oct. 30 on the website of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association of Cancer Research. The study abstract is available at http://cebp.aacrjournals.org/content/early/2012/10/28/1055-9965.EPI-12-0740.abstract.


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