Department of Behavioral Science, University of Kentucky, Lexington, KY 40536, USA.
Cancer. 2012 Jul 15;118(14):3645-53. doi: 10.1002/cncr.26678. Epub 2011 Dec 13.
Little research has identified the physical and mental health status of survivors of multiple primary cancer diagnoses.
By using data from the population-based 2009 National Health Information Survey, 154 survivors of multiple primary cancer diagnoses, 1427 survivors of a single cancer diagnosis, and 25,004 individuals without a history of cancer diagnosis were identified. The multiple cancer group was compared with the single cancer and no cancer groups with regard to physical and mental health status using analysis of covariance and binary logistic regression.
Relative to the no cancer group, the multiple cancer group reported significantly poorer mental health status, greater lifetime, recent, and current prevalence of a variety of medical conditions and comorbidities, and more health-related disability. Although observed group differences between the multiple cancer and single cancer groups were less pronounced than those between the multiple cancer and no cancer groups, a consistent pattern was also evident; the multiple cancer group reported significantly poorer status relative to the single cancer group across a range of mental and physical health and illness-related disability indices.
Diagnosis of 2 or more primary cancers (excluding nonmelanoma skin cancers) is associated with increased risk for poorer physical and mental health status over and above that associated with diagnosis of a single primary cancer. Survivors of multiple and single primary cancer diagnoses should be considered as distinct subgroups, and increased attention should be devoted to the unique status and needs of survivors of multiple primary cancer diagnoses.
鲜有研究确定了多重原发性癌症患者的身心健康状况。
利用基于人群的 2009 年国家健康信息调查数据,确定了 154 例多重原发性癌症幸存者、1427 例单一癌症幸存者和 25004 例无癌症病史的个体。采用协方差分析和二元逻辑回归,将多重癌症组与单一癌症组和无癌症组进行比较,评估其身心健康状况。
与无癌症组相比,多重癌症组报告的心理健康状况明显较差,一生中、最近和当前患有多种疾病和合并症的比例更高,与健康相关的残疾率也更高。虽然多重癌症组和单一癌症组之间的观察到的组间差异不如多重癌症组和无癌症组之间的差异明显,但也存在一致的模式;与单一癌症组相比,多重癌症组在一系列身心健康和与疾病相关的残疾指标上报告的状况明显更差。
诊断出 2 种或以上原发性癌症(不包括非黑色素瘤皮肤癌)会增加身心健康状况不佳的风险,超过了诊断出单一原发性癌症的风险。多重原发性癌症和单一原发性癌症的幸存者应被视为不同的亚组,应更加关注多重原发性癌症幸存者的独特状况和需求。