Study On The Quality Of Life And Influence Factors For Six Common Cancers In Gansu Province

Objectives:To evaluate differences in quality of life(QOL)among lung cancer,breast cancer,colon cancer,esophageal cancer,hepatic cancer,and gastric cancer patients using the EQ-5D,FACTs,and SF-12 survey tools,and to discuss the effects of age,education,marital status,occupation,health status,and other factors on QOL among cancer patients,in order to provide scientific evidence for the improvement of their QOL.Methods:Patients with six common cancers in specialist hospitals and teaching hospitals from January,2014 to July,2014 were selected as the research population(n=827).Mean,standard deviation,percent,frequency,and effect size were calculated to describe the socio-demographic characteristics and disease status of the population.Different dimensions of QOL were tested using ANOVA,t-test,and Pearson's correlation.Multivariate linear regression was used to analyze significant variables.The discriminative properties of the EQ-5D and SF-12 surveys were compared against indicators of QOL using receiver operating characteristic curves.The statistical significance of the areas under the curves was tested by ANOVA and F-statistics were used to compare the efficiency between disease severity groups.Results:1.The study showed that the quality of life of cancer patients as a whole was significantly worse than that of the general population(F=27.45,P<0.01).Cancer patients have lower QOL than the general population on the physical function,and functional status dimensions.General health and the physical function had the lowest scores,at 30.14±22.16 and 43.64±32.53,respectively.2.There was a significant difference in the disease-related dimensions of quality of life among cancer patients compared to the general population(P<0.01).Lung cancer had the worst QOL,in which the physical status,emotional status,and functional status indicators had the lowest scores,at 61.50±20.65,65.54±20.40,and 30.51±19.26,respectively.On the dimension of pain,breast cancer had the lowest QOL(32.85±28.46);on the dimension of appetite loss,esophageal cancer had the lowest QOL(42.21 ±36.33);on the dimension of weight loss,esophageal cancer had the lowest QOL(59.78±32.03).3.Physical and Mental Health Composite Scores among patients with different cancers:Males had a higher quality of life than females.In terms of age,patients over 60 had the lowest quality of life.In terms of education,higher education was associated with a higher quality of life.Age,number of years since diagnosis,type of therapy,and marital status were significant influence factors affecting quality of life among cancer patients.Gender,number of years since diagnosis,marital status,type of therapy,and health insurance status were significant influence factors among lung cancer patients.Number of years since diagnosis,marital status,type of therapy,and health insurance status were significant influence factors among breast cancer patients.Age,number of years since diagnosis,and type of therapy were significant influence factors among liver cancer patients.Age,education,marital status,and type of therapy were significant influence factors among gastric cancer patients.4.Using the specificity and universality questionnaires can allow for a better evaluation of quality of life.There is a high correlation between mobility and routine activities in EQ-5D,and PCS in SF-12(r=0.215,P<0.05;r=0.242,P<0.05).There is a high correlation between anxiety/depression in EQ-5D,and MCS in SF-12(r=0.159,P<0.05).AUC was above 0.5 against the indicators of health-related quality of life for both tools.SF-12 was more efficient in discriminating cases than EQ-5D.Conclusion:1.Quality of life among cancer patients is not ideal and needs improvement.Physical function and functional status were important dimensions affecting QOL.2.Lung cancer patients had the worst quality of life among the six common cancers on multiple dimensions.Colon cancer patients had the lowest QOL in terms of social/family status as well as emotional status.Breast cancer patients had the lowest QOL in terms of pain experienced.Esophageal cancer patients had the lowest QOL in terms of appetite and weight loss.3.Demographic characteristics and treatment methods were important influence factors for the six common cancers in Gansu province.4.The specificity and universality questionnaires can be used to better evaluate quality of life among cancer patients.