Vermont Center for Behavior and Health, Office of Health Promotion Research, Department of Surgery, University of Vermont, 1 South Prospect Street, Rm. 4425, Burlington, VT, 05401, USA.
Department of Population Health Sciences and Carbone Cancer Center, University of Wisconsin, Madison, WI, USA.
Qual Life Res. 2018 May;27(5):1237-1247. doi: 10.1007/s11136-018-1807-6. Epub 2018 Feb 7.
Women diagnosed with ductal carcinoma in situ (DCIS) often experience adverse changes in health-related behaviors following diagnosis. The impact of health behaviors on long-term quality of life (QoL) in DCIS survivors has not been investigated.
We examined the association of post-diagnosis body mass index (BMI), physical activity, alcohol, and smoking with QoL among 1448 DCIS survivors aged 20-74 enrolled in the population-based Wisconsin in situ Cohort from 1997 to 2006. Health behaviors and QoL were self-reported during biennial post-diagnosis interviews. Physical and mental QoL were measured using the validated SF-36 questionnaire. Generalized linear regression was used to determine the association between behaviors and QoL with adjustment for confounders. Lagged behavior variables were used to predict QoL during follow-up and avoid reverse causation.
Women reported 3,536 QoL observations over an average 7.9 years of follow-up. Women maintaining a healthy BMI had on average a significantly higher summary measure score of physical QoL than obese women (normal versus obese: β = 3.02; 2.18, 3.85). Physical QoL scores were also elevated among those who were physically active (5 + h/week vs. none: β = 1.96; 0.72, 3.20), those consuming at least seven drinks/week of alcohol (vs. none; β = 1.40; 0.39, 2.41), and nonsmokers (vs. current smokers: β = 1.80; 0.89, 2.71). Summary measures of mental QoL were significantly higher among women who were moderately physically active (up to 2 h/week vs. none: β = 1.11; 0.30, 1.92) and nonsmokers (vs. current smokers: β = 1.49;0.45, 2.53).
Our results demonstrate that maintaining healthy behaviors following DCIS treatment is associated with modest improvements in long-term QoL. These results inform interventions aimed at promoting healthy behaviors and optimizing QoL in DCIS survivors.
诊断为导管原位癌（DCIS）的女性通常在诊断后经历健康相关行为的不良变化。健康行为对 DCIS 幸存者长期生活质量（QoL）的影响尚未得到调查。
我们研究了 1448 名年龄在 20-74 岁之间的 DCIS 幸存者在 1997 年至 2006 年期间参加基于人群的威斯康星原位队列研究后的诊断后体重指数（BMI）、体力活动、酒精和吸烟与 QoL 的关系。健康行为和 QoL 在每两年一次的诊断后访谈中报告。使用经过验证的 SF-36 问卷测量身体和心理健康 QoL。使用广义线性回归来确定行为与 QoL 之间的关联，并调整混杂因素。滞后行为变量用于预测随访期间的 QoL，以避免反向因果关系。
女性在平均 7.9 年的随访期间报告了 3536 次 QoL 观察结果。保持健康 BMI 的女性的身体 QoL 综合测量评分平均明显高于肥胖女性（正常与肥胖：β=3.02；2.18，3.85）。每周至少进行 5 小时体力活动的女性（与不活动相比：β=1.96；0.72，3.20）、每周至少饮用 7 杯酒的女性（与不饮酒相比：β=1.40；0.39，2.41）和不吸烟者（与当前吸烟者相比：β=1.80；0.89，2.71）的身体 QoL 评分也有所提高。每周适度进行体力活动（每周最多 2 小时与不活动相比：β=1.11；0.30，1.92）和不吸烟者（与当前吸烟者相比：β=1.49；0.45，2.53）的女性的心理健康综合测量评分明显更高。
我们的研究结果表明，在 DCIS 治疗后保持健康的行为与长期 QoL 的适度改善相关。这些结果为旨在促进 DCIS 幸存者的健康行为和优化 QoL 的干预措施提供了信息。
