Brown Derek S, Trogdon Justin G, Ekwueme Donatus U, Chamiec-Case Linda, Guy Gery P, Tangka Florence K, Li Chunyu, Trivers Katrina F, Rodriguez Juan L
Brown School, Washington University in St. Louis, St. Louis, Missouri.
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Am J Prev Med. 2016 Feb;50(2):255-61. doi: 10.1016/j.amepre.2015.07.020.
Breast cancer affects women's health-related quality of life negatively, but little is known about how breast cancer affects this in younger women aged 18-44 years. This study measures preference-based health state utility (HSU) values, a scaled index of health-related quality of life for economic evaluation, for younger women with breast cancer and compares these values with same-age women with other cancers and older women (aged ≥45 years) with breast cancer.
Data from the 2009 and 2010 Behavioral Risk Factor Surveillance System were analyzed in 2014. The sample included 218,852 women; 7,433 and 18,577 had histories of breast and other cancers. HSU values were estimated using Healthy Days survey questions and a published mapping algorithm. Linear regression models for HSU were estimated by age group (18-44 and ≥45 years).
The adjusted breast cancer HSU impact was four times larger for younger women than for older women (-0.097 vs -0.024, p<0.001). For younger women, the effect of breast cancer on HSU was 70% larger than that of other cancers (-0.097 vs -0.057, p=0.024).
Younger breast cancer survivors reported lower HSU values than older survivors, highlighting the impact of breast cancer on the physical and mental health of younger women. The estimates may be used to evaluate quality-adjusted life-years or expectancy for prevention or treatment of breast cancer. This study also indicates that separate quality of life adjustments for women by age group are important for economic analysis of public health breast cancer interventions.
乳腺癌会对女性与健康相关的生活质量产生负面影响，但对于18至44岁的年轻女性，乳腺癌如何影响她们的生活质量却鲜为人知。本研究测量了基于偏好的健康状态效用（HSU）值，这是一种用于经济评估的与健康相关生活质量的量化指标，研究对象为患有乳腺癌的年轻女性，并将这些值与患有其他癌症的同龄女性以及患有乳腺癌的老年女性（年龄≥45岁）进行比较。
2014年对2009年和2010年行为风险因素监测系统的数据进行了分析。样本包括218,852名女性；其中7,433名和18,577名有乳腺癌和其他癌症病史。使用“健康天数”调查问题和一种已发表的映射算法来估计HSU值。按年龄组（18 - 44岁和≥45岁）估计HSU的线性回归模型。
调整后的乳腺癌对HSU的影响在年轻女性中比老年女性大四倍（-0.097对-0.024，p<0.001）。对于年轻女性，乳腺癌对HSU的影响比其他癌症大70%（-0.097对-0.057，p = 0.024）。
年轻的乳腺癌幸存者报告的HSU值低于年长的幸存者，这突出了乳腺癌对年轻女性身心健康的影响。这些估计值可用于评估预防或治疗乳腺癌的质量调整生命年或预期寿命。本研究还表明，按年龄组对女性进行单独的生活质量调整对于公共卫生乳腺癌干预措施的经济分析很重要。
