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基于人群的研究:特定年龄段的结直肠癌长期和极长生存者与普通人群对照的健康相关生活质量。

Age-specific health-related quality of life in long-term and very long-term colorectal cancer survivors versus population controls - a population-based study.

机构信息

a Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.

b Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.

出版信息

Acta Oncol. 2019 May;58(5):801-810. doi: 10.1080/0284186X.2018.1557340. Epub 2019 Feb 8.

Abstract

Previous research suggests an age differential in health-related quality of life (HRQOL) among long-term (5-10 years post-diagnosis, LTS) colorectal cancer (CRC) survivors. Few studies have specifically addressed the association of age differentials with HRQOL for very long-term CRC survivors (>10 years post-diagnosis, VLTS) and non-cancer population controls. We aimed to assess possible deficits in HRQOL of disease-free CRC-LTS and CRC-VLTS in comparison with non-cancer population controls, and whether the observed pattern varies by age and time since diagnosis. We used data from the ncr urvivorship - multi-egional (CAESAR+) study in collaboration with five population-based German cancer registries. HRQOL from controls was accessed from the ebensqualität eutschland (LinDE) study. All respondents completed the European Organization for Research and Treatment of Cancer Quality of Life Core-30 questionnaire. We calculated least square means of HRQOL scores. Analyses were adjusted for age, sex, and education, where appropriate. The sample included 862 CRC-LTS, 400 CRC-VLTS and 1689 controls. CRC survivors reported overall good HRQOL but significantly poorer social functioning and more problems with dyspnea, constipation, diarrhea and finances than controls. When stratified by age, deficits in functioning and global health, and more problems with symptoms and finances were noted mainly among younger CRC survivors. Further stratification by time since diagnosis showed that similar deficits in HRQOL and symptoms were noted mainly among the younger CRC-LTS group when compared with controls. Generally, CRC-VLTS reported comparable HRQOL to controls. An exception was noted for diarrhea, whereby CRC survivors, regardless of age and time since diagnosis, reported significantly more problems with this symptom than controls. In comparison with non-cancer controls, disease-free CRC survivors reported overall good HRQOL but experience persistent specific detriments in HRQOL many years after diagnosis. In age stratified analyses, HRQOL deficits were noted mainly among younger CRC-LTS.

摘要

先前的研究表明,在长期(诊断后 5-10 年,LTS)结直肠癌(CRC)幸存者中,健康相关生活质量(HRQOL)存在年龄差异。很少有研究专门针对非常长的 CRC 幸存者(>10 年诊断后,VLTS)和非癌症人群对照者的年龄差异与 HRQOL 的相关性进行研究。我们旨在评估无疾病 CRC-LTS 和 CRC-VLTS 与非癌症人群对照者相比,HRQOL 可能存在的缺陷,以及观察到的模式是否因年龄和诊断后时间而有所不同。我们使用了与五个基于人群的德国癌症登记处合作开展的 ncr 生存研究 - 多区域(CAESAR+)研究的数据。对照组的 HRQOL 来自 ebensqualität eutschland(LinDE)研究。所有受访者均完成了欧洲癌症研究与治疗组织(EORTC)生活质量核心 30 问卷。我们计算了 HRQOL 评分的最小平方均值。分析根据年龄、性别和教育情况进行了调整。该样本包括 862 名 CRC-LTS、400 名 CRC-VLTS 和 1689 名对照组。CRC 幸存者报告整体 HRQOL 良好,但社会功能明显较差,呼吸困难、便秘、腹泻和财务问题比对照组更严重。按年龄分层时,主要是年轻的 CRC 幸存者出现功能和整体健康状况下降,以及更多的症状和财务问题。进一步按诊断后时间分层显示,与对照组相比,年轻的 CRC-LTS 组在 HRQOL 和症状方面存在类似的缺陷。一般来说,CRC-VLTS 报告的 HRQOL 与对照组相当。但腹泻例外,无论年龄和诊断后时间如何,CRC 幸存者报告的这种症状问题明显多于对照组。与非癌症对照组相比,无疾病的 CRC 幸存者报告整体 HRQOL 良好,但在诊断后多年仍存在特定的 HRQOL 持续下降。在年龄分层分析中,主要是年轻的 CRC-LTS 患者出现 HRQOL 缺陷。

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