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长期癌症幸存者的健康状况:基于澳大利亚人群样本的结果。

Health status of long-term cancer survivors: results from an Australian population-based sample.

作者信息

Eakin Elizabeth G, Youlden Danny R, Baade Peter D, Lawler Sheleigh P, Reeves Marina M, Heyworth Jane S, Fritschi Lin

机构信息

Cancer Prevention Research Centre, University of Queensland, Level 3, Public Health Building, Herston Road, Herston, Queensland 4006, Australia.

出版信息

Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10):1969-76. doi: 10.1158/1055-9965.EPI-06-0122.

Abstract

BACKGROUND

Despite considerable knowledge about the effect of cancer during the early stages of treatment and survivorship, understanding the longer-term effect of cancer has only recently become a priority. This study investigated the health implications of longer-term cancer survivorship in an Australian, population-based sample.

METHODS

Using the Australian National Health Survey, 968 longer-term cancer survivors were identified, along with 5,808 age- and sex-matched respondents without a history of cancer. Four measures of health effect were compared (quality of life, health status, days out of role, and mental well-being), using polytomous and logistic regression analyses controlling for other selected chronic conditions. These models were applied across both groups overall, across groups stratified by presence/absence of cancer, and other chronic conditions, as well as by tumor site.

RESULTS

Compared with matched respondents without cancer, longer-term cancer survivors reported significant decrements in health status, days out of role, and mental well-being (all P < 0.02), but not in quality of life. The likelihood of poor health outcomes (including quality of life) was much higher among survivors who also reported comorbid chronic conditions. Despite mixed results across tumor site, melanoma and prostate cancer survivors fared better across most outcomes.

CONCLUSIONS

Clear evidence of excess morbidity among Australian longer-term cancer survivors seems to be further exacerbated by the presence of comorbid chronic conditions. Consistent with recent U.S. studies, these results further support the importance of ongoing surveillance of the growing number of cancer survivors worldwide along with increased attention to interventions to improve long-term health outcomes.

摘要

背景

尽管在癌症治疗早期和生存阶段的影响方面已有相当多的了解,但了解癌症的长期影响直到最近才成为优先事项。本研究调查了澳大利亚基于人群的样本中癌症长期生存者的健康影响。

方法

利用澳大利亚国民健康调查,确定了968名癌症长期生存者,以及5808名年龄和性别匹配且无癌症病史的受访者。使用多分类和逻辑回归分析,比较了四种健康影响指标(生活质量、健康状况、失能天数和心理健康),并控制了其他选定的慢性病。这些模型在总体两组、按有无癌症和其他慢性病分层的组以及按肿瘤部位分层的组中均有应用。

结果

与匹配的无癌症受访者相比,癌症长期生存者在健康状况、失能天数和心理健康方面有显著下降(均P<0.02),但生活质量没有下降。报告有合并慢性病的生存者出现不良健康结果(包括生活质量)的可能性要高得多。尽管不同肿瘤部位的结果不一,但黑色素瘤和前列腺癌生存者在大多数结果方面表现较好。

结论

澳大利亚癌症长期生存者中存在过高发病率的明确证据似乎因合并慢性病的存在而进一步加剧。与美国最近的研究一致,这些结果进一步支持了对全球越来越多癌症生存者进行持续监测以及更加关注改善长期健康结果的干预措施的重要性。

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