Cancer Registry of Norway, Majorstuen, P.O. 5313, 0304, Oslo, Norway.
Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Qual Life Res. 2022 Apr;31(4):1057-1068. doi: 10.1007/s11136-021-03017-7. Epub 2021 Oct 26.
Breast cancers detected at screening need less aggressive treatment compared to breast cancers detected due to symptoms. The evidence on the quality of life associated with screen-detected versus symptomatic breast cancer is sparse. This study aimed to compare quality of life among Norwegian women with symptomatic, screen-detected and interval breast cancer, and women without breast cancer and investigate quality adjusted life years (QALYs) for women with breast cancer from the third to 14th year since diagnosis.
This retrospective cross-sectional study was focused on women aged 50 and older. A self-reported questionnaire including EQ-5D-5L was sent to 11,500 women. Multivariable median regression was used to analyze the association between quality of life score (visual analogue scale 0-100) and detection mode. Health utility values representing women's health status were extracted from EQ-5D-5L. QALYs were estimated by summing up the health utility values for women stratified by detection mode for each year between the third and the 14th year since breast cancer diagnosis, assuming that all women would survive.
Adjusted regression analyses showed that women with screen-detected (n = 1206), interval cancer (n = 1005) and those without breast cancer (n = 1255) reported a higher median quality of life score using women with symptomatic cancer (n = 1021) as reference; 3.7 (95%CI 2.2-5.2), 2.3 (95%CI 0.7-3.8) and 4.8 (95%CI 3.3-6.4), respectively. Women with symptomatic, screen-detected and interval cancer would experience 9.5, 9.6 and 9.5 QALYs, respectively, between the third and the 14th year since diagnosis.
Women with screen-detected or interval breast cancer reported better quality of life compared to women with symptomatic cancer. The findings add benefits of organized mammographic screening.
与因症状而发现的乳腺癌相比，筛查发现的乳腺癌需要的侵袭性治疗更少。有关筛查发现的乳腺癌与症状性乳腺癌相关生活质量的证据稀缺。本研究旨在比较挪威有症状、筛查发现和间期乳腺癌女性与无乳腺癌女性的生活质量，并调查诊断后第 3 年至第 14 年乳腺癌女性的质量调整生命年（QALY）。
本回顾性横断面研究聚焦于 50 岁及以上的女性。向 11500 名女性发送了一份包括 EQ-5D-5L 在内的自我报告问卷。多变量中位数回归用于分析生活质量评分（0-100 视觉模拟量表）与检测模式之间的关联。从 EQ-5D-5L 中提取代表女性健康状况的健康效用值。通过对按检测模式分层的女性在诊断后第 3 年至第 14 年每年的健康效用值求和，估计 QALY，假设所有女性都将存活。
调整后的回归分析显示，与有症状性癌症（n=1021）作为参考的女性相比，筛查发现（n=1206）、间期癌症（n=1005）和无乳腺癌（n=1255）女性的生活质量评分中位数更高，分别为 3.7（95%CI 2.2-5.2）、2.3（95%CI 0.7-3.8）和 4.8（95%CI 3.3-6.4）。有症状性、筛查发现和间期乳腺癌的女性在诊断后第 3 年至第 14 年期间将分别经历 9.5、9.6 和 9.5 个 QALY。
与有症状性癌症女性相比，筛查发现或间期乳腺癌女性报告的生活质量更好。这些发现增加了有组织的乳房 X 线筛查的益处。
