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Differences in quality of life between American and Chinese breast cancer survivors

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Abstract

Objective

It has been speculated that cancer survivors in Asia may have lower quality of life (QOL) compared with their Western counterparts. However, no studies have made international comparisons in QOL using a comprehensive measure. This study aimed to compare Chinese breast cancer survivors’ QOL with US counterparts and examine if demographic and medical factors were associated with QOL across groups.

Method

The sample consisted of 159 breast cancer patients (97 Chinese and 62 American) who completed the Functional Assessment for Cancer Therapy Breast Cancer (FACT-B) scale before the start of radiotherapy in Shanghai, China and Houston, USA.

Results

Higher income was associated with higher QOL total scores in both Chinese and American cancer patients, but QOL was not significantly associated with other factors including age, education, disease stage, mastectomy, and chemotherapy. Consistent with hypotheses, compared to their US counterparts, Chinese breast cancer survivors reported lower QOL and all four subdimensions including functional well-being (FWB), physical well-being (PWB), emotional well-being (EWB), and social well-being (SWB); they also reported more breast cancer-specific concerns (BCS). Differences were also clinically significant for Functional Assessment for Cancer Therapy General (FACT-G) scale total scores and the FWB subscale. After controlling for demographic and medical covariates, these differences remained except for the SWB and BCS. Furthermore, Chinese breast cancer survivors receiving chemotherapy reported significantly lower FACT-G scores than those who did not, but this difference did not emerge among US breast cancer survivors.

Discussion

Chinese breast cancer survivors reported poorer QOL on multiple domains compared to US women. Findings indicate that better strategies are needed to help improve the QOL of Chinese breast cancer survivors, especially those who underwent chemotherapy.

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Acknowledgments

Support was provided in part by the US National Cancer Institute (NCI) grants CA108084 and CA121503 (principal investigator, Lorenzo Cohen) and the American Cancer Society MRSGT-10-011-01-CPPB (principal investigator, Qian Lu). Partial support for Lorenzo Cohen was provided by the Richard E. Haynes Distinguished Professorship in Clinical Cancer Prevention. Jennifer McQuade is supported by an institutional T32 training grant and an ASCO Young Investigator Award.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Houston, 126 Heyne Building, Houston, 77204, TX, USA

    Qian Lu & Krystal Warmoth

  2. WuHan University, Wuhan, China

    Jin You

  3. The University of Texas School of Public Health, Houston, USA

    April Kavanagh

  4. Fudan University Shanghai Cancer Center, Shanghai, China

    Zhiqiang Meng, Zhen Chen, Jiayi Chen, Xiaoma Guo & Luming Liu

  5. University of Texas Health Science Center, Houston, USA

    Kavita D. Chandwani

  6. The University of Texas MD Anderson Cancer Center, Houston, USA

    George H. Perkins, Jennifer Leigh McQuade, Zhongxing Liao, Banu Arun & Lorenzo Cohen

  7. Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India

    Nelamangala V. Raghuram, Raghuram Nagarathna & Hongasandra Ramarao Nagendra

  8. Department of Palliative, Rehabilitation, and Integrative Medicine, Section of Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Lorenzo Cohen

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  1. Qian Lu
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  2. Jin You
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  18. Lorenzo Cohen
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Corresponding authors

Correspondence to Qian Lu or Lorenzo Cohen.

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The authors declare that they have no conflict of interest.

Additional information

The University of Texas School of Public Health, Houston, USA. Location when analyses were conducted

The University of Texas MD Anderson Cancer Center, Houston, USA. Location when data was collected

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Lu, Q., You, J., Kavanagh, A. et al. Differences in quality of life between American and Chinese breast cancer survivors. Support Care Cancer 24, 3775–3782 (2016). https://doi.org/10.1007/s00520-016-3195-1

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  • DOI: https://doi.org/10.1007/s00520-016-3195-1

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