Heins Marianne J, Korevaar Joke C, Hopman Petra E P C, Donker Gé A, Schellevis François G, Rijken Mieke P M
Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.
Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.
Cancer. 2016 Mar 15;122(6):962-70. doi: 10.1002/cncr.29853. Epub 2016 Jan 7.
The number of cancer survivors is steadily increasing and these patients often experience long-lasting health problems. To make care for cancer survivors sustainable for the future, it would be relevant to put the effects of cancer in this phase into perspective. Therefore, the authors compared health-related quality of life (HRQOL) and health care use among cancer survivors with that of patients with chronic diseases.
Patients diagnosed at age >18 years with a cancer with a 5-year survival rate > 20% and no distant metastases at the time of diagnosis and patients aged >18 years with physician-diagnosed somatic chronic diseases without cancer were sent a questionnaire. HRQOL was measured with the RAND-36, a measure of HRQOL. Self-reported health care use was measured for general practitioner care, specialist care, rehabilitative care, physical therapy, ambulatory mental health care, and occupational health care.
A total of 601 cancer survivors and 1052 patients with chronic diseases without cancer were included in the current study. Multimorbidity was observed in 63% of the cancer survivors and 61% of the patients with chronic diseases. The HRQOL of the cancer survivors was significantly better than that of patients with chronic diseases after adjustment for age and sex. For the mental functioning subscale, no significant differences were found between the 2 groups. Cancer survivors were found to be less likely to have visited a general practitioner or cardiologist compared with patients with chronic diseases.
When considering physical HRQOL and health care use, cancer survivors appear to fare better than the average patient with chronic diseases. No difference in mental functioning was observed in the current study.
癌症幸存者的数量在稳步增加，这些患者常常面临长期的健康问题。为使癌症幸存者的护理在未来具有可持续性，了解这一阶段癌症的影响很有必要。因此，作者比较了癌症幸存者与慢性病患者的健康相关生活质量（HRQOL）及医疗保健利用情况。
向年龄大于18岁、确诊为5年生存率大于20%且诊断时无远处转移的癌症患者，以及年龄大于18岁、经医生诊断患有非癌症躯体慢性病的患者发放问卷。采用RAND-36量表测量HRQOL，该量表用于衡量HRQOL。自我报告的医疗保健利用情况包括全科医生护理、专科护理、康复护理、物理治疗、门诊心理健康护理和职业健康护理。
本研究共纳入601名癌症幸存者和1052名非癌症慢性病患者。63%的癌症幸存者和61%的慢性病患者存在多种疾病。在对年龄和性别进行调整后，癌症幸存者的HRQOL显著优于慢性病患者。在心理功能子量表方面，两组之间未发现显著差异。与慢性病患者相比，癌症幸存者看全科医生或心脏病专家的可能性较小。
在考虑身体HRQOL和医疗保健利用情况时，癌症幸存者的情况似乎优于普通慢性病患者。本研究未观察到心理功能方面的差异。
