Health Status Of Cancer Patients Research Articles

Health status based on EQ-5D-5L for the cancer patient population in Malaysia

The EQ-5D is a common generic tool used in clinical trials and economic evaluations to evaluate the health-related quality of life as a proxy of health outcomes. To date, studies using EQ-5D-5L to evaluate the health status of cancer patients remain scarce in Malaysia. In this study, EQ-5D-5L dimensions, EQ-5D-5L index, and EQ-VAS scores were applied to assess the health status of Malaysian cancer patients. A cross-sectional study was conducted March-December 2022 to collect data relevant to the EQ-5D-5L valuation of health status via the Research Electronic Data Capture (REDCap) platform. Respondents rated their health states using EQ-5D-5L and EQ-VAS. Among the 235 respondents, the mean EQ-5D-5L index and EQ-VAS score were 0.76 (SD 0.223) and 81.06 (SD 16.36). Most of the patients reported some problems in the pain/discomfort and anxiety/depression dimensions. The level of education, stage of cancer, and comorbidity were significantly associated with better health status on EQ-5D-5L (p < 0.05) but only the stage of cancer was significantly associated with EQ-VAS scores. This study highlighted the disparities in self-reported health status across patients of different sociodemographic and medical profiles with EQ-5D-5L valuation. Thus, future research should use EQ-5D norm scores as a benchmark of comparison among cancer patients.

Global trends and knowledge-relationship of symptom clusters in cancer research: a bibliometric analysis over the past 20 years

Abstract Objective To use CiteSpace and VOSviewer to investigate the scientific production in the field of symptom clusters in cancer research. Methods The search was performed using the terms “symptom clusters,” “cancer,” and “oncology” on the Web of Science Core Collection database. The retrieval time was from 2001 to 2021, which covers the last 2 decades. Based on the production theory of scientific knowledge and the data mining of citations, data pertaining to the annual publications, journals, countries, organizations, authors, and keywords that produce symptom clusters in cancer research, as well as their cooperation (collaboration network), were extracted, and then both were clarified by the software tools VOSviewer (version 1.6.16) and CiteSpace (version 6.1.R2). Results A total of 1796 publications were retrieved between 2001 and 2021, and 473 relevant publications were included after screening. The results showed an increasing trend in published articles. The United States had the largest number of publications (261/473, 55.18%), followed by China and Canada. The University of California, San Francisco, was the most productive institution. Current research hotspots included the analysis of symptom clusters and symptom management in patients with breast cancer and lung cancer, as well as any advanced cancer and cancer cachexia; fatigue-related symptom clusters and depression-anxiety symptom cluster; and the impacts of symptom clusters on quality of life. The research frontiers included analysis between health-related quality of life and symptom clusters, data mining in symptom clusters, research on the mental health status of cancer patients, and study of the mechanism and biological pathways of symptom clusters. Conclusions The study provides insight into the global research perspective for the scientific progress on cancer symptom clusters, which suggests a growing scientific interest in this field, and more studies are warranted to guide symptom management.

Self-Management Strategy Clustering, Quality of Life, and Health Status in Cancer Patients Considering Cancer Stages.

In the cancer-care continuum, self-management can help cancer patients regardless of their treatment plan or cancer stage. However, research examining self-management strategy clusters considering cancer stages is lacking. Thus, we examined self-management strategy clusters considering cancer stages and the effects of self-management strategy clusters on quality of life (QoL) and overall health status. A total of 256 patients who completed both baseline and second surveys for a 6-month period ultimately participated in this prospective cohort study. To identify the interrelationship between self-management strategies measured by the Smart management strategies for health assessment tool (SAT), we conducted cluster analysis using a principal component analysis in varimax rotation and the k-mean clustering method. We also performed multivariate-adjusted analyses in QoL and overall health status comparisons by dividing the cancer stage into early (I, II) and advanced (III, IV). All patients experienced two domains of self-management strategies concurrently. However, self-management strategy clusters differed by cancer stage, and the effect of self-management strategy clusters on quality of life and overall health status also differed. Self-management strategy clusters effectively improved the quality of life and overall health status of the entire cohort of patients, even in patients with advanced-stage cancer. This study revealed that the pattern of using self-management strategies might differ by cancer stage. The strategy cluster positively affected QoL and overall health status in cancer patients. Identifying the self-management clusters of cancer patients with different cancer stages may have clinical implications for supporting their health management.

Length of caring duration increases burden and reduces health status of cancer patients’ family caregivers in Surabaya, Indonesia

Background and purpose: The duration of care taking of cancer patients can trigger stress which impacts on the emergence of a burden which further affects the physical health of the family caregivers. This study aims to determine the effect of caring duration on the burden and health status of cancer patient’s family caregivers. Methods: This was a cross-sectional study. Samples were 56 cancer patient’s family caregivers who were selected by a purposive sampling technique based on specified inclusion criteria from two public health centers (PHCs) in Surabaya Indonesia. Participants completed the questionnaire which comprised of questions on caring duration, caregiver burden scale and physical health status. Statistical tests using simple linear regression and multiple linear regression were performed. Results: The average age of family caregivers was 49.91 (SD=12.24), mostly female (66.7%), while half of the patients (51.8%) were a stage III cancer patients and the most frequent type of therapy (35%) received was chemotherapy. The average of caring duration was 4.44 (SD=1.92) years, score of burden was 51.07 (SD=18.45) and score health status was 60.32 (SD=10.81). After adjusted for age, gender, cancer stage and type of therapy, caring duration was significantly associated with increased burden of family caregivers (b=9.186, 95%CI: 7.85-10.10, p&lt;0.001) and with reduced health status (b=5.282, 95%CI: 4.50-5.85, p&lt; 0.001) Conclusion: The longer caring duration of cancer patients causes a higher burden and also a lower health status of family caregivers. Health workers and community have an important role in reducing the burden and improving the health status of caregivers by providing supports and appropriate prevention measures.

MALNUTRITION AMONG CANCER PATIENTS: ROLE OF SOCIAL SUPPORT

&#x0D; &#x0D; &#x0D; Malnutrition is linked with poorer outcomes following cancer treatment. This study determined the association between marital status, nutritional status and social support among cancer patients. This was a cross-sectional study involving 82 cancer patients receiving both outpatient and inpatient cancer treatment at Hospital Universiti Sains Malaysia (HUSM). Parameters investigated were socio-demography, nutritional status and social support. Nutritional status was assessed using the Patient Generated-Subjective Global Assessment (PG-SGA) while social support using Multidimensional Perceived Social Support Scales (MSPSS). Chi-Square or Fisher Exact test had been used for analysing the association between the variables. The prevalence of malnutrition assessed using PG-SGA was 69.5%. A total of 61% of the cancer patients experienced weight loss within a month. There was a statistically significant association between malnutrition and social support (p&lt;0.05). A total of 63.6% of the patients with high social support from friends reported having weight loss while 52.6% of those with moderate social support had weight gain. Good social support will determine the good quality of life among cancer patients, however, there were several other factors such as stage of cancer, the side effect of cancer treatment and poor dietary intake that determine the nutritional status of cancer patients. Thus, a holistic approach involving a multidisciplinary team must be taken for monitoring and improve the health status of cancer patients.&#x0D; &#x0D; &#x0D;

Health promoting effects of fermented foods against cancer: an updated concise review

The global cancer burden has increased, and about 9.6 million cancer-related deaths were recorded in 2018. Genetic makeup, unhealthy lifestyle, urbanization, obesity, and dietary preferences are key risk factors associated with cancer incidence and development. Next to lung cancer, colorectal cancer is the most perilous cancer type in terms of mortality rate. Diet plays a major role in colorectal cancer risk. The consumption of vegetables, unprocessed cereals, fish product, and fermented foods are associated with lower cancer risk, while raw and processed red meats and refined foods are associated with increased cancer risk. The anti-cancer properties of fermented foods and their possible mechanisms are summarized in this review. Some studies indicated that the consumption of fermented foods reduced the risk of cancer and improved the health status of cancer patients. However, some other research findings suggested that the intake of fermented foods was not associated with reduced cancer risk. Several signaling pathways (p38 MAPK, ERK1/2, energy deprivation, and death-receptor mediated pathways) are involved in the anti-proliferative and growth suppressive properties of fermented foods. Overall, the literature survey suggested that the consumption of fermented foods might reduce cancer risk and improve health status in association with other factors, such as genetics and healthy lifestyle.

Bone metastasis and skeletal-related events in patients with solid cancer: A Korean nationwide health insurance database study.

Bone is one of the most common sites of metastasis from advanced solid tumors. Bone metastasis is a leading cause of pain and increases the risk of skeletal-related events (SREs) in cancer patients. In addition to affecting the quality of life, it also increases the medical costs and mortality risk. We aimed to examine the occurrence of bone metastasis and SREs in Korean cancer patients using a nationwide health database. Using claims data from the National Health Insurance Service-National Sample Cohort (2002-2013), we extracted the data of bone metastasis patients diagnosed with any of the seven major cancers in Korea from January 2002 to December 2010. Selected SREs included pathologic fracture, spinal cord compression, radiation therapy, and palliative bone surgery. We used time-to-event analysis to estimate patient survival after bone metastasis. A total of 21,562 newly diagnosed cancer patients were identified; bone metastases developed in 1,849 patients (breast cancer, 18.8%; prostate cancer, 17.5%; lung cancer, 13.7%). The median time from primary cancer diagnosis to bone metastasis was 18.9 months. The cumulative incidence of SREs was 45.1% in all bone metastasis patients. The most common cancer type was lung cancer (53.4%), followed by liver (50.9%), prostate (45.9%), breast (43.6%), and colorectal (40.2%) cancers. Almost all SREs developed 1 month after bone metastasis, except in patients with breast and prostate cancers (median: 5.9 months in breast cancer and 4.7 months in prostate cancer). Survival duration after the development of bone metastasis was < 6 months in stomach, liver, colorectal, and lung cancer patients. Breast and prostate cancer patients survived for > 1 year after the occurrence of SREs. This study reveals the epidemiology of bone metastasis and SREs in Korean cancer patients, and the findings can be used to assess the actual bone health status of cancer patients.

Efficacy of Ice Ball Oral Care on Subjective-Objective Oral Health Status in Cancer Patients: A Pilot Study

Background/Objectives: Oral mucositis and oral discomfort are common side effects in cancer patients undergoing chemotherapy. The purpose of this study is to examine the efficacy of ice ball oral care on subjective-objective oral health status induced by chemotherapy in adult cancer patients among Korean Women . Method/Statistical analysis: Participants were randomly assigned either to the experimental group(n=15) that received ice ball oral care during chemotherapy or the control group(n=15) that received normal saline oral care during chemotherapy. Findings: There was a significant difference in oral mucositis, and oral discomfort between the two groups, and there were significant changes over time and the group by time interactions. Improvements/Applications: The findings of the study demonstrated that ice ball oral care was more effective than the normal saline oral care in improving subjective-objective oral health status in adult cancer patientss undergoing chemotherapy.

A Research Roadmap: Connected Health as an Enabler of Cancer Patient Support.

The evidence that quality of life is a positive variable for the survival of cancer patients has prompted the interest of the health and pharmaceutical industry in considering that variable as a final clinical outcome. Sustained improvements in cancer care in recent years have resulted in increased numbers of people living with and beyond cancer, with increased attention being placed on improving quality of life for those individuals. Connected Health provides the foundations for the transformation of cancer care into a patient-centric model, focused on providing fully connected, personalized support and therapy for the unique needs of each patient. Connected Health creates an opportunity to overcome barriers to health care support among patients diagnosed with chronic conditions. This paper provides an overview of important areas for the foundations of the creation of a new Connected Health paradigm in cancer care. Here we discuss the capabilities of mobile and wearable technologies; we also discuss pervasive and persuasive strategies and device systems to provide multidisciplinary and inclusive approaches for cancer patients for mental well-being, physical activity promotion, and rehabilitation. Several examples already show that there is enthusiasm in strengthening the possibilities offered by Connected Health in persuasive and pervasive technology in cancer care. Developments harnessing the Internet of Things, personalization, patient-centered design, and artificial intelligence help to monitor and assess the health status of cancer patients. Furthermore, this paper analyses the data infrastructure ecosystem for Connected Health and its semantic interoperability with the Connected Health economy ecosystem and its associated barriers. Interoperability is essential when developing Connected Health solutions that integrate with health systems and electronic health records. Given the exponential business growth of the Connected Health economy, there is an urgent need to develop mHealth (mobile health) exponentially, making it both an attractive and challenging market. In conclusion, there is a need for user-centered and multidisciplinary standards of practice to the design, development, evaluation, and implementation of Connected Health interventions in cancer care to ensure their acceptability, practicality, feasibility, effectiveness, affordability, safety, and equity.

Estado de salud oral antes, durante y después del tratamiento antineoplásico en un instituto de cáncer en Barranquilla, Colombia.

Chemotherapy and radiotherapy are aggressive treatments for cancer management. Both therapies make the stomatogatic system vulnerable to adverse effects on the oral mucosa and hard tissues. This may result in severe oral complications that can affect the quality of life of the oncologic patient. Consequently, oral diagnosis and interdisciplinary management by the stomatologist are critical for cancer treatment, regardless of its location. Objective. To determine the oral health status of cancer patients before, during and after antineoplastic treatment at a cancer institute in the city of Barranquilla, Colombia. Materials and Methods. A descriptive, longitudinal and prospective study of 131 cancer patients, was conducted. The study consisted of initial stomatological assessment of the antineoplastic therapy; classification according to the antineoplastic therapy given by the oncologist; a second stomatological assessment during treatment; and a final stomatological assessment or evaluation forty days after the end of therapy. Descriptive statistics, chi-square and MacNemar test were used to compare and identify variances at the different stages. Results. Female patients accounted for 69%, and breast cancer had 24% prevalence among the included subjects. At the initial stomatological assessment, high frequency lesions were identified, such as generalized biofilm-associated gingivitis in 69% of the cases, followed by oral candidiasis in 61%. The specific prevalence of lesions was 10.65%. In the second stomatological assessment, a greater frequency of periodontal abscesses was observed in 31%, and oral mucositis type II in 18%. The third clinical assessment showed significant changes in oral health status; an increase in the frequency of gingivitis was found in 9.9% (p&lt;0.001); unlike before and during, there was an increment in dental caries of 26.73% (p&lt;0.00000) at this last stage, root remains increased by 39.53% (p&lt;0.00000), and finally, xerostomia increased by 45%. Oral candidiasis was the only lesion that showed improvement. Conclusion. An increase in the number of lesions was observed during and after antineoplastic treatment. The oral cavity is susceptible to antineoplastic treatments; gingivitis, candidiasis, xerostomia, and mucositis were observed, among others conditions.

Utility Estimation of Health Status of Cancer Patients by Mapping for Cost-Utility Analysis

Background: It is important to obtain accurate information about the preferences of people for measuring quality-adjusted life years (QALYs), because it is necessary for cost-utility analysis. In this regard, mapping is a method to access this information. Therefore, the purpose of this study was to map Functional Assessment of Cancer Therapy – General (FACT-G) onto Short Form Six Dimension (SF-6D) in breast cancer patients to provide appropriate conditions for a detailed cost-utility analysis.&#x0D; Methods: This descriptive analytical study was conducted on 416 patients with breast cancer. The SF-6D and FACT-G questionnaires were completed for patients selected by consecutive sampling from the Imam Khomeini Cancer Institute in Tehran in 2018. The Ordinary Least Squares model was used to estimate the value of utility and the models' goodness of fit was evaluated using R2. In addition, models' predictive performance was assessed by Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Minimal Important Difference (MID) conducted between the observed and predicted SF-6D values. Models were validated using a 10-fold cross validation method.&#x0D; Results: Given the criteria of goodness of fit, model 2 was the best (R2 = 41.19 %). Moreover, findings of the predictive performance of models showed that model 2 was the best (MAE = 0.06943, RMSE = 0.09031, and MID = 0.0003).&#x0D; Conclusions: Findings showed that the developed algorithm had a good predictive ability. So, it can enable the policymakers and researchers to convert cancer-specific health-related quality of life instruments to preference-based instruments.

Heart Rate Variability as a Prognostic Factor for Cancer Survival - A Systematic Review.

An increasing cancer incidence affecting any age and social class is putting serious strain on populations and health care systems around the world. This systematic literature search aims (i) to examine the correlation of heart rate variability (HRV) and cancer patients’ prognosis, (ii) to examine the relationship of HRV and clinicopathological features, and (iii) to compare HRV between different patient groups, and between patient and control groups. We conducted a systematic literature review following the PRISMA Statement. We searched the PubMed and EMBASE databases for publications released by December 2017. The search terms were: “cancer” AND “heart rate variability” AND “human” NOT “animal” NOT “review.” A total of 19 studies were finally included in this review. Most publications were high-quality observational studies. The studies showed that higher HRV correlated positively with patients’ progression of disease and outcome. Thus, we conclude that individuals with higher HRV and advanced coping mechanisms seem to have a better prognosis in cancer progression. HRV appears to be a useful aspect to access the general health status of cancer patients.

The contribution of pain in determining the health status of cancer patients with bone metastases: A secondary analysis of data from three Phase III registration trials

We aimed to provide a simple, descriptive health-status profile for cancer patients with bone metastases, based on the EuroQol EQ-5D, a tool commonly used to measure health utility scores, and to evaluate its association with the Brief Pain Inventory (BPI), a legacy pain-assessment tool. Although pain is one of five health-status dimensions measured by the EQ-5D, our understanding of how pain relates to the other EQ-5D dimensions is limited. We derived data from 5500 patients with bone metastases who completed the EQ-5D and BPI. Regression analyses examined how BPI severity and interference scores correlated with EQ-5D utility scores and how BPI items associated with EQ-5D items, for the entire sample and by disease-type subgroup. Regardless of cancer site, the percentage of patients reporting moderate/severe problems in each of the five EQ-5D dimensions were pain/discomfort, 78%; usual activities, 58%; mobility, 55%; anxiety/depression, 57%; and self-care, 26%. BPI pain interference explained more of the variability in the EQ-5D utility scores than did pain severity (R2 =41% vs. 34%). BPI worst pain, average pain, pain now, interference with general activity, and interference with work significantly predicted EQ-5D pain/discomfort, with odds ratio estimates <1. Pain/discomfort was the worst-rated dimension of the EQ-5D in this population, but the relationship of this item to BPI pain severity was modest, suggesting that the single pain item of the EQ-5D may be of limited utility in studies for which pain is an endpoint. Health-status dimensions include more than pain. We examine the contribution of pain severity and pain-related functional interference in determining the health status of cancer patients with bone metastases. The pain dimension from a health-status measure may be an inadequate metric in clinical trials/clinical practice when pain is an important outcome.

Symptoms of Anxiety and Depression Are Associated With Satisfaction With Information Provision and Internet Use Among 3080 Cancer Survivors: Results of the PROFILES Registry.

Dissatisfaction with information provided by healthcare providers may be a reason for cancer survivors to seek health information on the Internet and may also result in more symptoms of anxiety and depression among this population. The aim of this study was to investigate whether anxious and depressive symptoms are associated with satisfaction with information provision and Internet use among cancer survivors. All individuals diagnosed with endometrial or colorectal cancer between 1998 and 2007 or lymphoma or multiple myeloma between 1999 and 2008 as registered in the Eindhoven Cancer Registry were invited for participation. In total, 4 446 survivors received a questionnaire including the 25-item European Organisation for Research and Treatment of Cancer Quality of Life Group Information questionnaire and Hospital Anxiety and Depression Scale; 69% responded (n = 3080). Having anxious (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.5-0.9; P < .05) or depressive symptoms (OR, 0.5; 95% CI, 0.4-0.7; P < .001), or both (OR, 0.4; 95% CI, 0.4-0.7; P < .001) were negatively associated with experienced helpfulness of the received information. Having depressive symptoms or having both depressive and anxious symptoms were negatively associated with satisfaction with information (OR, 0.5; 95% CI, 0.4-0.7; OR, 0.5; 95% CI, 0.4-0.7, respectively; P < .001). Having depressive symptoms was negatively associated with disease-related Internet use (OR, 0.69; 95% CI, 0.5-0.9; P < .05). The results may indicate that information provision is suboptimal, either because it is not adjusted to the mental health status of cancer patients or because it is unsatisfactory and thereby causing anxious and depressive symptoms among cancer patients. More attention should be paid to optimally adjust the information provision to the individual needs of the cancer patients for better mental health.

The value of bioelectrical impedance analysis and phase angle in the evaluation of malnutrition and quality of life in cancer patients--a comprehensive review.

Bioelectrical impedance analysis (BIA) and especially its derived parameter phase angle have been widely used in different populations. The variability of BIA measures has often been cited as a major limitation for its clinical use in evaluating nutritional status and overall health of patients. Cancer patients often present with malnourishment and cachexia, which complicate the course of treatment and affect outcomes. PubMed, CINAHL, EBSCO and Cochrane Library have been searched for relevant publications in English for BIA in cancer patients. Out of 197 total results, 27 original research articles related to BIA measures in cancer patients were included in this review. Studies indicate that the use of BIA and phase angle measures can benefit in the clinical management of cancer patients in multiple ways: in the prevention; diagnosis; prognosis; and outcomes related to treatments that affect nutritional and overall health status. Phase angle and fat-free mass measures were most commonly evaluated and correlated with nutritional status and survival rate. One limitation of BIA measures is the high interpatient variability which requires careful interpretation of results in the context of the individual patient rather than comparison with population data. The BIA and phase angle provide practitioners for the evaluation of nutritional and overall health status in cancer patients with a convenient and non-invasive technique and should be encouraged.

Validation of the EuroQol Five-dimensions - Three-Level Quality of Life Instrument in a Classical Indian Language (Odia) and Its Use to Assess Quality of Life and Health Status of Cancer Patients in Eastern India.

Background and Objectives:The EuroQol five-dimensions – 3-level (EQ5D) is a versatile quality of life (QOL) instrument with five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and a visual analog scale. It can be used to calculate quality-adjusted life years. We aimed to evaluate the validity, reliability, and responsiveness of an Odia version of EQ5D and to study the QOL of cancer patients in our part of the country as cancer treatment in India still focuses largely on longevity due to scarcity of resources.Materials and Methods:The EQ5D tool was translated into Odia language in collaboration with the EQ group. This tool and the World Health Organization-5 (WHO-5) questionnaires were administered to 155 surgical outpatients and 150 cancer patients in two hospitals of Eastern India. The convergent and discriminant validities (construct validity), concurrent validity, reliability (test-retest method of administering the tool to a part of the population after 7–14 days), and the internal consistency (Cronbach's alpha) were measured using preestablished hypotheses. The data from the cancer patients were analyzed separately.Results:The QOL worsened with age and was worse in cancer patients proved that the tool had good construct validity. The Anxiety Depression dimension had good correlation with all the dimensions WHO-5 (rho > 0.4) indicating a good concurrent validity. Internal consistency and reliability of the tool were good (Cronbach's alpha > 0.7). Cancer patients had a poor QOL (mean EQ5D index 0.37SD 0.4) with male patients, patients with Grade II cancer or referred for pain care services and those with living spouses reporting worse QOL.Conclusions:The Odia version of the EQ5D has good reliability and validity for the measurement of health status in cancer and outpatient department patients. Cancer patients in this part of the country have a poor QOL and may need a closer look at pain management and improved societal support systems.

Physical activity in relation to quality of life in newly diagnosed colon cancer patients: a 24-month follow-up

Self-reported health status in cancer patients is an independent predictor of medical outcomes. This study investigated the association between changes in recreational physical activity in colon cancer survivors and quality of life (QoL) across a 24-month follow-up beginning at diagnosis. Patients (n = 453) diagnosed with stage II colon cancer were recruited from the North Carolina Central Cancer Registry from 2009 to 2011. Patients were interviewed annually about health behaviors (e.g., dietary intake, physical activity, alcohol and tobacco use), socioeconomic variables, and treatment. To index QoL, the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and Short Form-12 (SF-12) were utilized. Baseline vigorous exercise showed a positive correlation with the Functional Assessment of Cancer Therapy-General (FACT-G) Colorectal Cancer Scale (CCS) (β = 0.15, 95% CI 0.07-0.23), FACT-C (β = 0.39, 95% CI 0.06-0.72), and Trial Outcome Index (TOI) (β = 0.28, 95% CI 0.01-0.55). Race modified the association between vigorous activity and the FACT-G (P interaction = 0.010), FACT-C (P interaction = 0.020), TOI (P interaction < 0.010), and the PCS (P interaction < 0.010). As compared to no change, increasing physical activity over a 24-month period following diagnosis significantly improved scores from the FACT-G (β = 3.13, 95% CI 0.48-5.77, P trend = 0.054), FACT-C (β = 3.51, 95% CI 0.35-6.68, P trend = 0.08) TOI (β = 2.46, 95% CI 0.16-4.75, P trend = 0.04), and PCS of the SF-12 (β = 3.28, 95% CI 0.93-5.63, P trend < 0.01). Vigorous exercise is a significant predictor of higher QoL in stage II colon cancer patients. Patients with increased recreational physical activity have significantly improved QoL over 24 months following diagnosis.

Assessing non-cancer-related health status of US cancer patients: other-cause survival and comorbidity prevalence.

With advances in prevention, screening, and treatment, cancer patients are living longer; hence, non-cancer-related health status will likely play a larger role in determining their life expectancy. In this study, we present a novel method for characterizing non-cancer--related health status of cancer patients using population-based cancer registry data. We assessed non-cancer-related health status in the context of survival from other causes of death and prevalence of comorbidities. Data from the Surveillance, Epidemiology, and End Results program (2000-2006) were used to analyze cancer patients' survival probabilities by cause of death. Other-cause survival was estimated using a left-truncated survival method with the hazard of death due to other causes characterized as a function of age. Surveillance, Epidemiology, and End Results data linked to Medicare claims (1992-2005) were used to quantify comorbidity prevalence. Relative to the US population, survival from a non-cancer-related death was higher for patients diagnosed with early stage breast and prostate cancer but lower for lung cancer patients at all stages. Lung cancer patients had worse comorbidity status than did other cancer patients. The present study represents the first attempt to evaluate the non-cancer-related health status of US cancer patients by cancer site (breast, prostate, colorectal, and lung) and stage. The findings provide insight into non-cancer-related health issues among cancer patients and their risk of dying from other causes.

PCN124 Lost Productivity in Population of Cancer Patient's Close Relatives in Poland

Cancer more than other diseases concerns not only patients themselves, but also close relatives of patients. The aim of this study was to estimate lost productivity in a population of close relatives of cancer patients who provide them with home care. Survey on a representative sample of Polish economically active population of close relatives to cancer patients was planned. To assess the impact of cancer on productivity of relatives to cancer patients a modified questionnaire WPAI-SHP was used. The WHO performance scale was used to assess general health status of cancer patients. Human capital approach was used to estimate the absenteeism and presenteeism costs. Values are presented in Euro (exchange rate: 1 EUR=4.20 PLN). A total of 23,518 persons were questioned between August 2011 and April 2012. Of them 112 (0.48%) met inclusion criteria and completed WPAI-SHP questionnaire but only 98 persons completed questionnaire properly and were finally included in calculation. The mean age of included persons was 40.2±12.5 years and the average declared weekly work time was 42.7±14.1 hours. The average percent work time missed due to close relatives cancer was 4.7% and corresponded to a weekly average time of the absence of 1.9 hours. In contrast, the percent of working impairment due to cancer of close relatives was estimated at 21.0% and corresponded to weekly average productivity loss of 7.3 hours. When projected on total population, the estimated indirect costs associated with absenteeism amounted to about 154.5 million EUR and were significantly lower than the estimated costs of presenteeism – 607.4 million EUR. The analysis showed that the loss of productivity in a population of close relatives of cancer patients have important implications for the Polish economy, however less pronounced than costs of productivity loss measured in cancer population (1,935 billion EUR).

Abstract 5019: Quality of life and racial disparities in cancer

Abstract The purpose of this study was to analyze effects and interactions of quality of life and cancer in a diverse population. In the last two decades rates of cancer decreased in the general population, yet significant disparities to racial minorities continue to exist, including preventive actions, choice of cancer treatment and quality of life. Since studies have shown that quality of life data can be a significant independent predictor of survival duration for cancer patients, it is highly relevant to analyze racial disparities in regard to this matter. To extract factors that are potentially predictive of or associated with quality of life we analyzed a diverse population of non-cancer individuals as well as individuals who had been diagnosed with one or more forms of cancer (lung, prostate, colon, breast or a combination) using the Cohort V 2002 baseline dataset from the SEER Medicare Health Outcomes Survey linked database. The SF-36® instrument that was used for this resource is a short-form health survey with 36 questions which yields physical and mental health summary measures, allowing us to analyze underlining causes for racial disparities in cancer incidence and treatment, quality of life and several other covariates. Multivariate linear regression models were used for the entire patient sample to estimate the difference among races (White/ Black or African American/ Other) in terms of the standardized mental health score. The covariates we were able to include next to race and mental health in the model were: cancer diagnosis, current treatment, gender, marital status and level of education. With a total of 108,210 patients with valid form, 86.2% were White, 8.4% Black and 5.4% of other race. The cancer rates were 17.8%, 13.0%, and 12.7% respectively and were significantly different among races. Significant mental health score differences exist among races in the non-cancer as well as the cancer population and were found to be significantly lower for the latter. But these differences in the mental score were not statistically significant among different races after adjusting for the covariates. Most importantly significant differences were observed in the mental health scores depending on the type of cancer a patient was treated for. The results that were found in this study indicate a positive relationship between quality of life for cancer patients and the type of cancer they were treated for rather than their race. Racial disparities may thus at least partially be explained by the form of cancer and/or treatment different groups of cancer patients are receiving. Factors that may further influence the mental health status of cancer patients positively include being married, being female and having an education higher than a high school diploma. Future studies will need to analyze further covariates as well as the various specific molecular factors of specific cancer types and/or treatment modalities as underlying causes for racial disparities in cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5019. doi:10.1158/1538-7445.AM2011-5019