Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Cancer. 2021 Oct 15;127(20):3847-3855. doi: 10.1002/cncr.33762. Epub 2021 Jul 8.
The purpose of this study was to examine the health-related quality of life of sexual minority survivors in comparison with heterosexual survivors.
Four hundred eighty eligible survivors participated in a telephone survey that measured survivors' outcomes, which consisted of physical and mental quality of life and self-rated fair or poor health. These survivors were diagnosed with stage I, II, or III colorectal cancer an average of 3 years before the survey and were recruited from 4 cancer registries. Using forward selection with generalized linear models or logistic regression models, the authors considered 4 domains-personal factors, environmental factors, health condition characteristics, and body function and structure-as correlates for each survivorship outcome.
The authors found that unadjusted physical quality of life and self-rated fair/poor health were similar for all survivors. Sexual minority survivors had poorer unadjusted mental quality of life in comparison with heterosexual survivors. After adjustments for covariates, this difference was no longer statistically significant. Three domains (personal factors, health condition characteristics, and body function and structure) explained colorectal cancer survivors' fair/poor health and 46% of the variance in physical quality of life, whereas 56% of the variance in mental quality of life was explained by personal factors, body function and structure, and environmental factors.
This study has identified modifiable factors that can be used to improve cancer survivors' quality of life and are, therefore, relevant to ongoing efforts to improve the survivorship experience.
本研究旨在比较性少数幸存者与异性恋幸存者的健康相关生活质量。
480 名符合条件的幸存者参与了一项电话调查，该调查测量了幸存者的结果，包括身体和心理健康以及自评健康状况一般或较差。这些幸存者在调查前平均被诊断患有 I 期、II 期或 III 期结直肠癌 3 年，并从 4 个癌症登记处招募。使用广义线性模型或逻辑回归模型的向前选择，作者考虑了 4 个领域-个人因素、环境因素、健康状况特征和身体功能与结构-作为每个生存结果的相关因素。
作者发现，所有幸存者的未经调整的身体生活质量和自评健康状况一般或较差相似。与异性恋幸存者相比，性少数幸存者未经调整的心理健康较差。在调整了协变量后，这种差异不再具有统计学意义。三个领域（个人因素、健康状况特征和身体功能与结构）解释了结直肠癌幸存者的健康状况一般或较差，以及身体生活质量的 46%的方差，而心理健康的 56%的方差由个人因素、身体功能与结构和环境因素解释。
本研究确定了可改变的因素，这些因素可用于提高癌症幸存者的生活质量，因此与正在努力改善生存体验相关。
