Health-related quality of life among women with a history of breast cancer in Europe.

Abstract

e19615 Background: Due to the improvement in breast cancer (BC) detection and treatment, the prevalence of women with a history of BC is increasing. Yet, few international community-based studies have been conducted to examine the health-related quality of life (HRQoL) of women following diagnosis and treatment. Methods: Using data from the 2010 EU (UK, Germany, France, Italy, and Spain) National Health and Wellness Survey (NHWS), women with a history of breast cancer (BC+ group) were compared with women without a history of breast cancer (BC- group) on HRQoL (using the physical (PCS) and mental component summary (MCS) scores and health state utilities (SF6D) from the SF-12v2) controlling for demographics (age, education, etc), comorbidity burden (Charlson comorbidity index), and health characteristics (smoking, etc). Further, among just the BC+ group, predictors of HRQoL were examined. Results: A total of 579 women (2.0%) reported a history of BC in the EU. The mean age for BC+ women was 60.6 (standard deviation (SD)=10.1) and women had been diagnosed a mean of 9.6 years (SD=7.2). Most BC+ women were currently cancer free (76.9%) though 33.7% were still receiving drugs (hormonal therapies or others). Despite being mostly cancer free, BC+ women reported significantly lower levels of PCS (Adjusted means = 45.8 vs. 48.3, p<.05) and health state utilities (Adjusted means = 0.69 vs. 0.71, p<.05) relative to BC- women, even after adjusting for demographics, comorbidity burden, and health characteristics. No significant differences were observed on MCS scores. Subsequent analyses of just the BC+ group revealed that the primary predictors of health state utilities included age (b=0.002), employment (b=0.43), exercise behavior (b=0.04), alcohol use (b=0.04), comorbidity burden (b=-0.01), years diagnosed (b=0.002), and current cancer stage (b’s=-0.01 to -0.08) (all p’s<.05). Conclusions: The diminished HRQoL in BC+ women in the EU may be related to long-term persistent complications from BC treatments. From a public health perspective, prevention initiatives, special support and further attention on improving HRQoL among these women should be given, particularly as the prevalence rates of those with a history of cancer continue to rise.