Health-related quality of life does not differ between short-term, long-term and very long-term cancer survivors in the Swedish general population

Abstract

Time since cancer diagnosis is rarely accounted for in population-based studies of health-related quality of life (HRQL) among cancer survivors. Therefore, this study aimed to assess the relationship between time since cancer diagnosis and impairments in HRQL among short-term, long-term and very long-term cancer survivors in the general population. A cross-sectional population-based survey of 4910 Swedish adults aged 40-79 years was conducted between April and June 2008. Three hundred and nineteen cases of cancer were identified, and 4591 participants reported no cancer. Analysis of co-variance (95% confidence intervals), adjusting for age, gender, education, marital status and non-cancer co-morbidity, was performed to compare HRQL ratings, as measured by the European Organisation for Research and Treatment of Cancer QLQ-C30, between short-term (<5 years since diagnosis [YSD]), long-term (5-10 YSD) and very long-term (>10 YSD) cancer survivors, and with that of a no-cancer control group. No significant differences were observed between the survivor groups across the HRQL scales, with the exception of fatigue and appetite loss, which were greater among the short-term survivors compared with the very long-term survivors. For the majority of the HRQL scales, ratings were significantly poorer in the short-term survivors compared with controls. Long-term survivors had significantly reduced global quality of life, physical function, social function and fatigue, compared with controls. Differences observed between groups were largely of limited clinical significance. HRQL of very long-term survivors did not differ from controls. Although HRQL was similar between short-term, long-term and very long-term survivors, when compared with the background population, findings suggest that some functional impairments and symptoms are present even at 5-10 YSD.