Quality of life and health status of Indonesian women with breast cancer symptoms before the definitive diagnosis: A comparison with Indonesian women in general.

Hari Setyowibowo,Sawitri S Sadarjoen,Aulia Iskandarsyah,Marit Sijbrandij,Joke A M Hunfeld,Fredrick Dermawan Purba,Jan Passchier

doi:10.1371/journal.pone.0200966

Hari Setyowibowo, Sawitri S Sadarjoen + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0200966

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Journal: PloS one	Publication Date: Jul 19, 2018
Citations: 13	License type: CC BY 4.0

Affiliation: Padjadjaran University, Erasmus MC

Abstract

ObjectivesBreast cancer (BC) is prevalent in low and middle-income countries (LMICs) where the majority of cases are diagnosed in late stages. The aims of this study were: (1) to assess quality of life (QOL) and health status of Indonesian women with BC symptoms before definitive diagnosis; (2) to compare QOL and health status between women with BC symptoms before definitive diagnosis and Indonesian women in general; (3) to evaluate the association between demographic variables (age, residence, social economic status and education level) and QOL within the Indonesian women with BC symptoms before definitive diagnosis.MethodsWe used WHOQOL-BREF to measure QOL and EQ-5D-5L for health status. Multivariate analysis of covariance (MANCOVA) was used to compare QOL and health status between women with BC symptoms and women from the general Indonesian population in order to control for confounders. Regression analyses were used for testing the association between the demographic variables, QOL, and health status.ResultsIn comparison with the data from the women from the general population (n = 471), the women with BC symptoms (n = 132) reported lower QOL, especially in physical and psychological domains. They also reported more problems in all dimensions of health status. Higher education and monthly income were positively associated with QOL and health status among the women with BC symptoms.ConclusionBefore receiving a definitive diagnosis, women who visit hospitals with symptoms of BC, report a lower QOL and health status than women in general. Our results suggest that healthcare providers should provide targeted strategies for women with BC symptoms to improve their QOL.

Highlights

Breast cancer (BC) is the most frequently diagnosed malignant tumor among women in both high-income countries (HICs) and low and middle-income countries (LMICs) [1]
Higher education and monthly income were positively associated with quality of life (QOL) and health status among the women with BC symptoms
The diagnostic process of BC and its treatments are often associated with negative effects that can lead to lower quality of life (QOL) [4, 5]

Summary

Introduction

Breast cancer (BC) is the most frequently diagnosed malignant tumor among women in both high-income countries (HICs) and low and middle-income countries (LMICs) [1]. The incidence of BC in LMICs is lower than for HICs, but mortality rates in LMICs are higher than in HICs because of advanced-staged diagnosis and inadequate access to care [2]. The mortality rates have been decreasing in many HICs since around 1990 due to early detection and improved treatment [2]. Throughout the process of hospital care, from diagnosis to treatment, the BC examinations and treatments affect the physical, psychological and social aspects of the life of a woman, which can significantly reduce her QOL, increase psychological distress [6], and uncertainty [7], negatively affect her body image and sexuality [8], illness perception [9], and increase unmet health needs [10]. Most investigations explore various issues after definitive diagnosis, e.g., QOL in women with BC during treatment [9, 11, 12] and QOL in BC survivors [13,14,15]

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