Associations of Age, Gender, and Family Income with Quality of Life in Children With Advanced Cancer

Abstract

Background: Children with cancer often experience decreased quality of life (QOL) throughout the illness trajectory. The purpose of this study was to explore the associations of demographic characteristics with QOL in children with advanced cancer. Methods: This secondary analysis was part of a larger randomized clinical trial that evaluated the efficacy of a legacy intervention for children (7–17 years) with relapsed/refractory cancer and their primary parent caregivers. Assessments included child self-reports on the Pediatric Quality of Life Inventory (PedsQL) Cancer Module. Researchers used descriptive and linear regression statistical methods. Results: Children ( n = 128) averaged 10.9 years (SD = 3.0). The majority were female ( n = 68, 53%), white ( n = 107, 84%), had a hematologic malignancy ( n = 67, 52%), with family incomes of $50,000 or less ( n = 81, 63.3%). Statistically significant positive associations of both age and income level with PedsQL scores were observed ( p < .05) but not gender ( p > .05). The strongest correlations for age were with the procedural anxiety ( beta = 0.42), treatment anxiety ( beta = 0.26), and total ( beta = 0.28) scores (all p < .01). In general, there was a positive correlation between family income levels and PedsQL scores ( p < .05). The strongest correlations for income were with nausea ( R = 0.49), appearance ( R = 0.44), pain, and treatment anxiety (both R = 0.42) (all p < .01). Associations adjusted for age remained essentially the same (all p < .01). Discussion: Children with advanced cancer with lower family income and younger age are at high risk for poorer QOL. Oncology nurses should seek to identify families who may benefit from additional resources to promote QOL.

Associations between Demographics and Quality of Life in Children in the First Year of Cancer Treatment

“…Older children reported worse quality of life, which is clinically seen with adolescents tolerating cancer treatment worse than toddlers. Our findings contrast with two studies, one in children with leukemia, 2 and in children with advanced cancer, 6 in which younger children had worse reported QOL. In the study of children with leukemia, perhaps this difference was related to a younger age range in the study, or because leukemia is more common in young children, whereas our study examined children with all cancer diagnoses.…”

“…7 Although the results are mixed, it appears that female gender and younger age are related to worse QOL, and older age is associated with more nausea. 2,[5][6][7] Thus, we sought to examine sex, race/ethnicity, age, and socio-economic (SES) differences in QOL in children in the first year of treatment for any type of cancer. We used questionnaires and a novel objective biologic measure to examine QOL.…”

“…Disparities in SES, race, and ethnicity can no longer be ignored in health care research. New work is emerging on the association of financial burden with worse QOL in children newly diagnosed with cancer, 16 children undergoing stem cell transplant, 17 children with advanced cancer, 6,18 and children who have completed cancer therapy. 19 In our data set, education level of parent and zip code were included as surrogate variables for SES.…”

Associations between demographics and quality of life in children in the first year of cancer treatment

“…Symptom distress and decreased quality of life (QOL) has been well documented among children with cancer, 1 but little is known regarding the demographic characteristics that could be targeted for interventions. The few studies in the literature examining demographic differences in the QOL of children with cancer are limited to children with leukemia, 2–4 children with advanced cancer, 5,6 and survivors of childhood cancer 7 . Although the results are mixed, it appears that female gender and younger age are related to worse QOL, and older age is associated with more nausea 2,5–7 .…”

“…The few studies in the literature examining demographic differences in the QOL of children with cancer are limited to children with leukemia, 2–4 children with advanced cancer, 5,6 and survivors of childhood cancer 7 . Although the results are mixed, it appears that female gender and younger age are related to worse QOL, and older age is associated with more nausea 2,5–7 . Thus, we sought to examine sex, race/ethnicity, age, and socioeconomic (SES) differences in QOL in children in the first year of treatment for any type of cancer.…”