The Impact of Socioeconomic Determinants on the Quality of Life of Moroccan Breast Cancer Survivors Diagnosed Two Years Earlier at the National Institute of Oncology in Rabat.

Rachid Ismaili,Abderraouf Hilali,Rachid Bekkali,Ahmed Nejmeddine,Hind Mimouni,Leila Loukili,Bouchra Haddou Rahou,Imane El Haouachim,Yoshitsugu Chigusa

doi:10.1155/2021/9920007

Abstract

Introduction The objective of this study was to investigate the impact of socioeconomic determinants on the quality of life of Moroccan women with breast cancer two years after their diagnosis who are followed up at the National Institute of Oncology (INO) in Rabat. Methods This is a cross-sectional study that was conducted between May 2019 and September 2020. The sample size was 304 women. Data were collected using the EORTC QLQ-C30 and EORTC QLQ-BR 23 questionnaires in the Moroccan dialect. Results The mean age of participants was 53.5 ± 12.4 years, where the majority resided in urban areas and more than half were illiterate. Moreover, three-quarters of the survivors were not working, and almost all have basic medical coverage. Nearly one-third of the respondents had experienced discrimination from those around them, and nearly half attributed the decrease in income to their state of health. In addition, 38.2 percent of participants stated that they had great difficulty living on their monthly income after the illness, whereas more than half of the survivors had a good quality of life in terms of overall health (GHS/QOL). Besides, social function obtained the highest score, while emotional function obtained the lowest score. Furthermore, financial difficulty was the most distressing symptom. Indeed, income adjustment after the disease, discrimination, distance between home and treatment center, professional status, and medical coverage were correlated with GHS/QOL. Regression analysis revealed that income adjustment after illness and discrimination were significant predictors of GHS/QOL. Conclusion The data suggest establishing a financial support program and the development of education and awareness-raising policies to combat discrimination.

Highlights

Introduction e cancer incidence rate inMorocco is 139.6 cases per 100,000, and the mortality rate is estimated to be 86.9 per 100,000
Survival of breast cancer patients has improved significantly due to early detection and advances in oncology treatment [2, 3]. e average 5-year survival rate has been estimated to be 85% in developed countries, but only 50–60% in developing countries [4, 5]
On the other hand, according to data published in the latest Greater Casablanca Cancer Registry Report 2008–2012, the overall survival at 5 and 7 years for breast cancer cases was 79% and 65%, respectively [7]

Summary

Materials and Methods

It has been validated in numerous tumor localizations It includes thirty (30) items divided into five functional scales (physical, role, cognitive, emotional, and social), three symptomatic scales (fatigue, pain, nausea, and vomiting), and global health and quality of life scale. It has been tested in the United States, Australia, Europe, and Japan and has demonstrated high reliability and validity across continents [26, 27]. E EORTC QLQ-BR23 questionnaire is a complementary module, which is specific to breast cancer It comprises twenty-three (23) items distributed as follows: four functional scales exploring body image, sexual activity, sexual pleasure, outlook and four symptomatic scales exploring therapeutically specific side. In case of missing items, multi-items scores were calculated as the mean of nonmissing items if at least half of the items from the corresponding scale had been completed

Results

Quality of Life

Discussion