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.

Propaganda and Education Can Improve the Quality of Life of Patients With Urologic Cancer Before Surgery

“…Previous studies supported our ndings. A large population-based study consisting of 266505 cases showed low physical function, distress and reduced QoL were more common among cancer patients than in people without cancers (15). Particularly, Shin et al compared the QoL of 331 urologic cancer survivors and 1177 healthy subjects.…”

Reliability and validity of the Brief Emotional Experience Scale (BEES) for mood monitoring

“…An additional measure included in the present study is the K10 (Kessler et al, 2002;. This is because the K10 has been, and continues to be, one of the most popular psychological distress measures in the literature (Some examples: Every-Palmer et al, 2020;Furukawa et al, 2003;Joshy et al, 2020;Lace et al, 2019;Nagel et al, 2020;Slade et al, 2011). In our study, we expected the K10 to be strongly positively associated with the DASS-21, and strongly negatively associated with the BEES balanced score.…”

Identifying and handling unbalanced baseline characteristics in a non-randomized, controlled, multicenter social care nurse intervention study for patients in advanced stages of cancer

“…Higher scores indicate a better QoL (36,37). For secondary outcomes, patients' health literacy was assessed by means of a validated assessment tool (HLS-EU-Q6 (38), score ranges between 1 and 4; score is grouped into insu cient (1-2 score), problematic (2-3 scores), and su cient (3)(4)). The relationship between physicians and patients was measured by the quality of the doctor-patient communication using an adapted version of the PRA-D (score ranges from 5 to 35; higher scores indicate better doctor-patient communication) (39).…”

“…Oncological diseases are prevalently associated with mental disorders such as depression, anxiety disorders and insomnia (2,3). Depending on the type of cancer and the stage of the disease, there is also a high incidence of disability, which also contributes to a low quality of life (4). Medical care of psychosocial burdens of disease in the context of a cancer diagnosis are heterogeneously dealt with and distinct services are provided.…”