Department of Molecular Medicine and Surgery, Unit of Upper Gastrointestinal Research, Karolinska Institutet, Stockholm, Sweden.
Psychooncology. 2013 Jun;22(6):1369-74. doi: 10.1002/pon.3147. Epub 2012 Aug 8.
Time since cancer diagnosis is rarely accounted for in population-based studies of health-related quality of life (HRQL) among cancer survivors. Therefore, this study aimed to assess the relationship between time since cancer diagnosis and impairments in HRQL among short-term, long-term and very long-term cancer survivors in the general population.
A cross-sectional population-based survey of 4910 Swedish adults aged 40-79 years was conducted between April and June 2008. Three hundred and nineteen cases of cancer were identified, and 4591 participants reported no cancer. Analysis of co-variance (95% confidence intervals), adjusting for age, gender, education, marital status and non-cancer co-morbidity, was performed to compare HRQL ratings, as measured by the European Organisation for Research and Treatment of Cancer QLQ-C30, between short-term (<5 years since diagnosis [YSD]), long-term (5-10 YSD) and very long-term (>10 YSD) cancer survivors, and with that of a no-cancer control group.
No significant differences were observed between the survivor groups across the HRQL scales, with the exception of fatigue and appetite loss, which were greater among the short-term survivors compared with the very long-term survivors. For the majority of the HRQL scales, ratings were significantly poorer in the short-term survivors compared with controls. Long-term survivors had significantly reduced global quality of life, physical function, social function and fatigue, compared with controls. Differences observed between groups were largely of limited clinical significance. HRQL of very long-term survivors did not differ from controls.
Although HRQL was similar between short-term, long-term and very long-term survivors, when compared with the background population, findings suggest that some functional impairments and symptoms are present even at 5-10 YSD.
在针对癌症幸存者健康相关生活质量（HRQL）的基于人群的研究中，很少考虑癌症诊断后的时间。因此，本研究旨在评估在一般人群中，短期、长期和非常长期癌症幸存者的癌症诊断后时间与 HRQL 损害之间的关系。
2008 年 4 月至 6 月期间，对 4910 名年龄在 40-79 岁的瑞典成年人进行了一项基于人群的横断面调查。确定了 319 例癌症病例，4591 名参与者报告没有癌症。采用协方差分析（95%置信区间），调整年龄、性别、教育、婚姻状况和非癌症合并症，比较了短期（<5 年癌症诊断后[YSD]）、长期（5-10 YSD）和非常长期（>10 YSD）癌症幸存者与无癌症对照组之间的 HRQL 评分，使用欧洲癌症研究和治疗组织的 EORTC QLQ-C30 进行测量。
在 HRQL 量表上，幸存者组之间没有观察到显著差异，但短期幸存者的疲劳和食欲丧失除外，与非常长期幸存者相比，短期幸存者的疲劳和食欲丧失更大。对于大多数 HRQL 量表，短期幸存者的评分明显低于对照组。与对照组相比，长期幸存者的总体生活质量、身体功能、社会功能和疲劳明显降低。与对照组相比，各组之间观察到的差异在很大程度上具有有限的临床意义。非常长期幸存者的 HRQL 与对照组没有差异。
尽管短期、长期和非常长期幸存者的 HRQL 相似，但与背景人群相比，研究结果表明，即使在 5-10 年 YSD 后，仍存在一些功能障碍和症状。
