疲劳、生活质量与遵行世界癌症研究基金会健康行为指南行为的关联：在英格兰 5835 例乳腺癌、前列腺癌和结直肠癌生存者和幸存者中的横断面研究。
Fatigue, quality of life and associations with adherence to the World Cancer Research Fund guidelines for health behaviours in 5835 adults living with and beyond breast, prostate and colorectal cancer in England: A cross-sectional study.
机构信息
Leeds Institute of Health Sciences, University of Leeds, Clarendon Way, Leeds, LS2 9NL, UK.
Department of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
出版信息
Cancer Med. 2023 Jun;12(11):12705-12716. doi: 10.1002/cam4.5899. Epub 2023 Apr 6.
BACKGROUND
Many individuals living with and beyond cancer (LWBC) have ongoing quality of life (QoL) issues, including fatigue. The World Cancer Research Fund (WCRF) provides health behaviour recommendations for people LWBC, and there is some evidence linking adherence to these with improved QoL.
METHODS
Adults LWBC (specifically breast, colorectal or prostate cancer) completed a survey covering health behaviours (diet, physical activity, alcohol consumption and smoking), fatigue (FACIT-Fatigue Scale, version 4) and a broad measure of QoL (EQ-5D-5L descriptive scale). Participants were categorised as meeting/not meeting WCRF recommendations, using the following cut-offs classified as meeting the guidelines: ≥150 min physical activity/week, fruit and vegetables (≥5 portions/day), fibre (≥30 g fibre per day), free sugar (<5% of total calories from free sugar), fat (<33% total energy), red meat (<500 g/week), processed meat (none), alcohol consumption (<14 units/week) and not a current smoker. Logistic regression analyses explored associations between WCRF adherence and fatigue and QoL issues, controlling for demographic and clinical variables.
RESULTS
Among 5835 individuals LWBC (mean age: 67 years, 56% female, 90% white, breast 48%, prostate 32% and colorectal 21%), 22% had severe fatigue and 72% had 1+ issue/s on the EQ-5D-5L. Adhering to physical activity recommendations (odds ratio [OR] = 0.88, confidence interval [CI] = 0.77-0.99), meeting various dietary recommendations (fruit and vegetables OR = 0.79; CI = 0.68-0.91, free sugar OR = 0.85; CI = 0.76-0.96, fat OR = 0.71; CI = 0.62-0.82, red meat OR = 0.65; CI = 0.50-0.85) and not smoking (OR = 0.53, CI = 0.41-0.67) were associated with decreased odds of experiencing severe fatigue. Adhering to physical activity guidelines (OR = 0.71, CI = 0.62-0.82) was also associated with decreased odds of having 1+ QoL issue/s.
CONCLUSIONS
Adherence to various WCRF recommendations, particularly the recommendation for physical activity, was associated with less fatigue and better QoL in a large UK cohort of people living with and beyond breast, colorectal or prostate cancer. Multi-component interventions designed to support people LWBC to improve health behaviours, in line with the levels recommended by the WCRF, may also improve QoL.
背景
许多癌症患者及其康复者（LWBC）存在持续的生活质量（QoL）问题，包括疲劳。世界癌症研究基金会（WCRF）为 LWBC 人群提供了健康行为建议，并且有一些证据表明，遵循这些建议与改善 QoL 相关。
方法
特定患有乳腺癌、结直肠癌或前列腺癌的 LWBC 成年人（即）完成了一项涵盖健康行为（饮食、身体活动、饮酒和吸烟）、疲劳（FACIT-Fatigue Scale，第 4 版）和广泛的 QoL 衡量标准（EQ-5D-5L 描述性量表）的调查。参与者根据以下标准分为符合/不符合 WCRF 建议：每周≥150 分钟的身体活动、水果和蔬菜（≥5 份/天）、纤维（每天≥30 克纤维）、游离糖（总卡路里的游离糖含量＜5%）、脂肪（总能量的＜33%）、红色肉类（每周＜500 克）、加工肉类（无）、饮酒量（每周＜14 单位）和不吸烟。使用逻辑回归分析方法，控制人口统计学和临床变量后，探讨了 WCRF 坚持情况与疲劳和 QoL 问题之间的关联。
结果
在 5835 名 LWBC 个体中（平均年龄：67 岁，56%为女性，90%为白人，乳腺癌占 48%，前列腺癌占 32%，结直肠癌占 21%），22%的人有严重疲劳，72%的人在 EQ-5D-5L 上有 1+个问题。遵循身体活动建议（比值比 [OR] = 0.88，95%置信区间 [CI] = 0.77-0.99）、符合各种饮食建议（水果和蔬菜 OR = 0.79；CI = 0.68-0.91，游离糖 OR = 0.85；CI = 0.76-0.96，脂肪 OR = 0.71；CI = 0.62-0.82，红色肉类 OR = 0.65；CI = 0.50-0.85）和不吸烟（OR = 0.53，CI = 0.41-0.67）与降低严重疲劳的几率相关。遵循身体活动指南（OR = 0.71，CI = 0.62-0.82）也与降低 1+个 QoL 问题的几率相关。
结论
在英国一个大型乳腺癌、结直肠癌或前列腺癌患者及其康复者队列中，遵循各种 WCRF 建议，特别是身体活动建议，与疲劳程度降低和 QoL 改善相关。为了改善 QoL，还可以设计多方面的干预措施，以支持 LWBC 人群改善与 WCRF 建议相符的健康行为。
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