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The association between chronic disease burden and quality of life among breast cancer survivors in Missouri

  • Epidemiology
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Abstract

Greater chronic disease burden may decrease quality of life (QOL) of breast cancer survivors. Our objective was to investigate the association between chronic disease burden and QOL in breast cancer survivors at 1 year post-diagnosis. We analyzed cross-sectional data collected 1 year post-diagnosis from a sample of female breast cancer survivors identified from the Missouri cancer registry. We used eight RAND-36 subscales to assess physical, emotional, and social functioning QOL domains. Using Katz’s measure of comorbidity, we computed chronic disease burden (0, 1, and 2+). Multivariable general linear models for each QOL subscale were used to examine associations between chronic disease burden and QOL after controlling for potential covariates: socio-demographic, clinical, psychosocial, behavioral risk factors, and access to medical care. Participants (n = 1089) were 58-year old on average (range 27–96) and mostly White (92%), married (68%), had at least a high school education (95%), and had health insurance (97%). Sixty-six percent of survivors had a chronic disease burden score of 0, 17% had 1, and 17% had 2+. Chronic disease burden was significantly associated with each QOL subscale in crude models (P < 0.001). In fully adjusted models, chronic disease burden was still significantly correlated with six subscales, but not with the emotional well-being and role limitations due to emotional problems subscales. One year post-diagnosis, breast cancer survivors with higher chronic disease burden had lower physical and social functioning than survivors without additional health conditions. These differences were not fully explained by relevant covariates. Identifying modifiable targets for intervention will be critical for improving QOL outcomes among survivors who have other chronic health conditions.

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Acknowledgments

This research was supported in part by grants from the National Cancer Institute (CA112159, CA91842). The funders did not have any role in the design of the study; the analysis and interpretation of the data; the decision to submit the manuscript for publication; or the writing of the manuscript. We thank Dr. Jeannette Jackson-Thompson and the staff of the Missouri Cancer Registry at the University of Missouri-Columbia for data collection; the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, Missouri, for the use of the Health Behavior, Communication, and Outreach Core; and Drs. Amy McQueen and Sandi Pruitt for review and comments on early versions of this manuscript.

Conflict of interest

All authors of this manuscript have no commercial associations that might pose a conflict of interest in connection with the submitted article. All funding sources supporting the work and all institutional or corporate affiliations of the authors are acknowledged at the end of the text.

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Authors and Affiliations

  1. Department of Medicine, Division of Health Behavior Research, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 6700, St. Louis, MO, 63108, USA

    Anjali D. Deshpande, Julianne A. Sefko, Donna B. Jeffe & Mario Schootman

  2. Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, 63110, USA

    Anjali D. Deshpande, Donna B. Jeffe & Mario Schootman

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  1. Anjali D. Deshpande
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  2. Julianne A. Sefko
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Correspondence to Anjali D. Deshpande.

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Deshpande, A.D., Sefko, J.A., Jeffe, D.B. et al. The association between chronic disease burden and quality of life among breast cancer survivors in Missouri. Breast Cancer Res Treat 129, 877–886 (2011). https://doi.org/10.1007/s10549-011-1525-z

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