Abstract
BackgroundThe Kuwaiti perspective on quality of life (QOL) in breast cancer is important because it adds the contribution from a country where the disease affects women at a relatively younger age and seems to be more aggressive. We used the EORTC QLQ – C30 and its breast-specific module (BR-23) to highlight the health-related QOL of Kuwaiti women with breast cancer, in comparison with the international data, and assessed the socio-demographic and clinical variables that predict the five functional scales and global QOL (GQOL) scale of the QLQ – C30.MethodsParticipants were consecutive clinic attendees for chemotherapy, in stable condition, at the Kuwait Cancer Control Center.ResultsThe 348 participants were aged 20–81 years (mean 48.3, SD 10.3); 58.7% had stages III and IV disease. Although the mean scores for QLQ – C30 (GQOL, 45.3; and five functional scales, 52.6%–61.2%) indicated that the patients had poor to average functioning, only 5.8% to 11.2% had scores that met the </= 33% criterion for problematic functioning, while 12.0% to 40.0% met the >66% criterion for more severe symptoms. Most (47.8%–70.1%) met the >66% criterion for "good functioning" on the BR-23 functional scales. The mean scores of the QLQ – C30 indicated that, despite institutional supports, Kuwaiti women had clinically significantly poorer global QOL and functional scale scores, and more intense symptom experience, in comparison with the international data (i.e., </= 10% difference between groups). For the BR-23, Kuwaiti women seemed to have clinically significantly better functional scale scores, but more severe symptoms, especially systemic side effects and breast symptoms. Younger women had poorer HRQOL scores. In regression analysis, social functioning accounted for the highest proportion of variance for GQOL.ConclusionThe relatively high number that met the criterion for good functioning on the functional scales is an evidence base to boost national health education about psychosocial prognosis in cancer. In view of the poor performance on the symptom scales, clinicians treating Kuwaiti women with breast cancer should prepare them for the acute toxicities of treatment and address fatigue. The findings call for the institution of a psycho-oncology service to address psycho-social issues.
Highlights
The Kuwaiti perspective on quality of life (QOL) in breast cancer is important because it adds the contribution from a country where the disease affects women at a relatively younger age and seems to be more aggressive
Health – related QOL (HRQOL) assessments in oncology facilitate doctor – patient communication, they point to areas where patients may experience serious problems, they can be used as diagnostic tools for problem- oriented follow – up care, and the data are strong predictors of survival [6,7]
Analysis of a large international database of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTC QLQ – C30) indicated that, compared with subjects from the UK, physical and social functioning were less important in predicting the global QOL of subjects from Islamic countries, while cognitive functioning was more influential for South Asia and Latin America [10]
Summary
The Kuwaiti perspective on quality of life (QOL) in breast cancer is important because it adds the contribution from a country where the disease affects women at a relatively younger age and seems to be more aggressive. Analysis of a large international database of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTC QLQ – C30) indicated that, compared with subjects from the UK, physical and social functioning were less important in predicting the global QOL of subjects from Islamic countries, while cognitive functioning was more influential for South Asia and Latin America [10] This obviates the need to assess the local perspectives on international QOL instruments, so that the data can be used to guide the choice of interventions and for cross-cultural comparisons to contribute to the emerging QOL theory [11]. Disease – free women tend to have global QOL scores similar to the general population [21]
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