A systematic review of quality of life instruments in long-term breast cancer survivors.

Ishveen Chopra,Khalid M Kamal

doi:10.1186/1477-7525-10-14

Abstract

BackgroundBreast cancer is the most common cancer in women, representing 16% of all female cancers. According to the American Cancer Society, long-term cancer survival is defined as more than five years of survivorship since diagnosis, with approximately 2.5 million breast cancer survivors (BCS) in 2006. The long-term effects from breast cancer and its treatment have been shown to have positive and negative effects on both recovery and survivors' quality of life (QoL). The purpose of the study was to identify QoL instruments that have been validated in long-term BCS and to review the studies that have used the QoL instruments in this population.MethodsA systematic literature search was conducted from January 1990 to October 2010 using electronic databases. Instruments validated and used in BCS were included in the review. In addition, QoL studies in long-term BCS using the validated instruments were reviewed. The search was limited to studies in English language. Studies of BCS of less than five years after initial diagnosis, any clinical or review studies were excluded.ResultsThe review identified a total of 12 instruments (10 disease-specific, 2 condition-specific) validated in long-term BCS. According to the QoL framework proposed by Ferrell and colleagues, three instruments (Quality of Life-Cancer Survivors, Quality of Life in Adult Cancer Survivors Scale, and Quality of Life Index-Cancer Version) evaluated all four domains (physical, psychological, social, and spiritual) of QoL. A review of the psychometric evaluation showed that Quality of Life in Adult Cancer Survivors Scale has acceptable reliability, validity, and responsiveness in long-term BCS compared to other disease-specific instruments. The review also yielded 19 studies that used these QoL instruments. The study results indicated that age-group, ethnicity, and type of treatment influenced different aspects of QoL.ConclusionsThere is a significant impact of breast cancer on QoL in long-term BCS. The review can help researchers and clinicians select the most appropriate instruments to assess the changes in QoL in BCS.

Highlights

Fatigue Symptom Inventory (FSI) and Multidimensional Fatigue Symptom Inventory (MFSI) were the two condition-specific instruments validated in long-term breast cancer survivors (BCS) and were included in the review
According to the quality of life (QoL) framework proposed by Ferrell et al, three of the identified diseasespecific instruments (QOL-CS, QLACS, and QLI-CV) evaluated all four domains of QoL and included items consistent with survivor’s concerns [20,24,25]
The findings suggested that the unpredictable nature of breast cancer and its treatment coupled with the presence of other diseases or functional disabilities of aging resulted in poorer QoL, especially in the health/functioning, socioeconomic, and psychological/spiritual domains

Summary

Introduction

Breast cancer is the most common cancer in women, representing 16% of all female cancers [1]. Breast cancer incidence and death rates generally increase with age; women older than 45 years are at the greatest risk [3]. According to the American Cancer Society (ACS), a long-term cancer survivor is defined as an individual who has survived five or more years since the diagnosis of cancer [6]. Breast cancer patients are at an increased risk of developing physical conditions (e.g., fatigue, sleep disturbances, and pain) and psychological distress (e.g., depression, anxiety, negative thoughts, fear of cancer recurrence and death, sense of aloneness, sexual, and body image problems) after diagnoses that adversely affect their overall QoL and survivorship [7]. According to the American Cancer Society, long-term cancer survival is defined as more than five years of survivorship since diagnosis, with approximately 2.5 million breast cancer survivors (BCS) in 2006. The purpose of the study was to identify QoL instruments that have been validated in long-term BCS and to review the studies that have used the QoL instruments in this population

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