School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, S Columbia St, Chapel Hill, NC, 27599-7460, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive N.C, Chapel Hill, NC, 27599, USA.
J Cancer Surviv. 2019 Oct;13(5):739-748. doi: 10.1007/s11764-019-00792-8. Epub 2019 Aug 22.
Few population-based studies have examined the prevalence of cardiovascular disease (CVD) and risk factors, quality of life (QOL), and health behaviors of cancer survivors and their spouses. This case-control study aimed to fill this gap using the data from a set of large-scale surveys of individuals and families across the USA.
Data were obtained from the 2010-2015 Medical Expenditure Panel Survey (MEPS). Using one-to-many (1:5) propensity score matching, we identified cancer survivors (N = 1037) and noncancer-matched controls (N = 5185), as well as survivor spouses (N = 1038) and matched controls (N = 5190). We used weighted multivariable logistic and linear regressions to examine the categorical and numerical outcomes.
Compared with noncancer controls, survivors have higher rates of stroke (p < .05), hypertension (p < .05), high cholesterol (p < .01), fair or poor health (p < .0001), and report self-reported worse physical QOL scores (PCS) (p < .0001). A higher percentage of survivors report receiving BP checks (p < .01), serum cholesterol assessments (p < .001), routine physical checkups (p < .01), blood stool tests (p < .05), colonoscopies (p < .0001), and flu vaccinations (p < .05). Survivor spouses, compared to their respective matched controls, reported higher rates of serum cholesterol testing (p < .001), routine physical checkups (p < .01), and flu vaccinations (p < .01).
Compared to the general population, cancer survivors are at higher risk for CVD, report worse physical QOL, and, along with their spouses, more frequently receive certain preventive health care services.
There is a need for intervention to more fully engage cancer survivors and spouses in lifestyle behavior change associated with decreased CVD and related risk factors and improved QOL.
很少有基于人群的研究调查过心血管疾病（CVD）及相关风险因素、癌症幸存者及其配偶的生活质量（QOL）和健康行为的流行率。本病例对照研究旨在利用来自美国个人和家庭大规模调查的一组数据来填补这一空白。
数据来自 2010-2015 年医疗支出面板调查（MEPS）。通过一比五（1:5）的倾向评分匹配，我们确定了癌症幸存者（N=1037）和非癌症匹配对照（N=5185），以及幸存者配偶（N=1038）和匹配对照（N=5190）。我们使用加权多变量逻辑和线性回归来检查分类和数值结果。
与非癌症对照组相比，幸存者中风（p<0.05）、高血压（p<0.05）、高胆固醇（p<0.01）、健康状况一般或较差（p<0.0001）的比例更高，报告自我报告的身体 QOL 评分（PCS）较差（p<0.0001）。更高比例的幸存者报告接受血压检查（p<0.01）、血清胆固醇评估（p<0.001）、常规体检（p<0.01）、粪便潜血检查（p<0.05）、结肠镜检查（p<0.0001）和流感疫苗接种（p<0.05）。与各自的匹配对照相比，幸存者配偶报告接受血清胆固醇检查（p<0.001）、常规体检（p<0.01）和流感疫苗接种（p<0.01）的比例更高。
与一般人群相比，癌症幸存者患 CVD 的风险更高，身体 QOL 更差，而且他们的配偶更频繁地接受某些预防保健服务。
需要采取干预措施，使癌症幸存者及其配偶更充分地参与与降低 CVD 及相关风险因素和提高 QOL 相关的生活方式行为改变。
