Mols Floortje, Coebergh Jan Willem W, van de Poll-Franse Lonneke V
Center of Research on Psychology in Somatic Diseases, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands.
Eur J Cancer. 2007 Oct;43(15):2211-21. doi: 10.1016/j.ejca.2007.06.022. Epub 2007 Aug 8.
The consequences of cancer and its treatment on health-related quality of life (HRQL) and health care utilisation among elderly long-term cancer survivors have rarely been studied. However, the impact can be different for older compared to younger patients due to the higher prevalence of comorbid diseases, a higher risk of treatment-related complications and because they often receive different therapies compared to younger patients. Therefore, this study addressed the following questions; do HRQL and health care utilisation differ between younger and elderly cancer survivors, and are those differences age or disease related.
A population-based, cross-sectional survey among 1893 long-term survivors of endometrial cancer, prostate cancer and non-Hodgkin's lymphoma was conducted using a cancer registry. HRQL was measured by the SF-36 and health care utilisation was measured with a self-reported questionnaire. Results were compared to a normative population. Patients with disease progression were excluded resulting in a total number of 1112 patients to be analysed.
Young non-Hodgkin lymphoma survivors (<70 years) reported lower vitality, bodily pain and general health compared to the normative population while older (70 years) survivors did not differ from the norm. Young lymphoma survivors experienced better physical functioning compared to older survivors. Young endometrial cancer survivors experienced less bodily pain compared to the normative population while older survivors did not differ from the norm. Young endometrial cancer survivors experienced better physical and role functioning compared to older survivors. Young prostate cancer survivors reported less bodily pain compared to the norm while older survivors did not. Young prostate cancer survivors reported higher scores on physical functioning compared to older survivors. Age, comorbid diseases, educational level and current occupation influenced HRQL significantly. Both younger and older cancer survivors visited their medical specialist, but not their GP, significantly more often compared to the age-matched general Dutch population. Both younger and older cancer survivors only sporadically used additional care services after cancer treatment.
HRQL of older and younger survivors is comparable, with the exception of physical functioning which is lower in older survivors. This difference in physical functioning was probably not caused by cancer because physical functioning among cancer survivors did not differ much compared to an age-matched normative population. Both younger and older long-term cancer survivors visited their medical specialist often but only sporadically used additional care services after cancer treatment.
癌症及其治疗对老年长期癌症幸存者健康相关生活质量（HRQL）和医疗保健利用的影响鲜有研究。然而，由于老年患者合并症患病率较高、治疗相关并发症风险较高，且与年轻患者相比往往接受不同的治疗，其影响可能与年轻患者不同。因此，本研究探讨了以下问题：年轻和老年癌症幸存者的HRQL和医疗保健利用情况是否存在差异，以及这些差异与年龄还是疾病相关。
利用癌症登记处对1893名子宫内膜癌、前列腺癌和非霍奇金淋巴瘤的长期幸存者进行了一项基于人群的横断面调查。HRQL通过SF-36量表测量，医疗保健利用情况通过自我报告问卷测量。结果与正常人群进行比较。排除疾病进展患者后，共1112名患者纳入分析。
年轻的非霍奇金淋巴瘤幸存者（<70岁）与正常人群相比，活力、身体疼痛和总体健康状况较差，而老年（≥70岁）幸存者与正常人群无差异。年轻淋巴瘤幸存者的身体功能比老年幸存者更好。年轻的子宫内膜癌幸存者与正常人群相比身体疼痛较少，而老年幸存者与正常人群无差异。年轻的子宫内膜癌幸存者比老年幸存者身体和角色功能更好。年轻的前列腺癌幸存者与正常人群相比身体疼痛较少，而老年幸存者与正常人群无差异。年轻的前列腺癌幸存者身体功能得分比老年幸存者更高。年龄、合并症、教育水平和当前职业对HRQL有显著影响。年轻和老年癌症幸存者看专科医生的频率均显著高于年龄匹配的荷兰普通人群，但看全科医生的频率并非如此。年轻和老年癌症幸存者在癌症治疗后仅偶尔使用额外的护理服务。
除身体功能老年幸存者较低外，年轻和老年幸存者的HRQL相当。身体功能的这种差异可能不是由癌症引起的，因为癌症幸存者的身体功能与年龄匹配的正常人群相比差异不大。年轻和老年长期癌症幸存者看专科医生的频率均较高，但在癌症治疗后仅偶尔使用额外的护理服务。
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