Shridevi Subramaniam1, Yek-Ching Kong1, Karuthan Chinna2,3, Merel Kimman4, Yan-Zheng Ho5, Nadiah Saat1, Rozita Abdul Malik6, Nur Aishah Taib7, Matin Mellor Abdullah8, Gerard Chin-Chye Lim9, Nor-Saleha Ibrahim Tamin10, Yin-Ling Woo11, Kian-Meng Chang12, Pik-Pin Goh1, Cheng-Har Yip8, Nirmala Bhoo-Pathy2. 1. National Clinical Research Centre, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur, Malaysia. 2. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 3. School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia. 4. Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, AZ Maastricht, The Netherlands. 5. Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia. 6. Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 7. Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 8. Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia. 9. Department of Radiotherapy & Oncology, National Cancer Institute, Putrajaya, Malaysia. 10. Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia. 11. Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 12. Department of Haematology, Ampang Hospital, Ampang, Selangor, Malaysia.
Abstract
OBJECTIVES: Quality of life and psychological well-being are important patient-centered outcomes, which are useful in evaluation of cancer care delivery. However, evidence from low-income and middle-income countries remains scarce. We assessed health-related quality of life (HRQoL) and prevalence of psychological distress (anxiety or depression), as well as their predictors, among cancer survivors in a middle-income setting. METHODS: Through the Association of Southeast Asian Nations Costs in Oncology study, 1490 newly diagnosed cancer patients were followed-up in Malaysia for 1 year. Health-related quality of life was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EuroQol-5 (EQ-5D) dimension questionnaires at baseline, 3 and 12 months. Psychological distress was assessed by using Hospital Anxiety and Depression Scale. Data were modeled by using general linear and logistic regressions analyses. RESULTS: One year after diagnosis, the mean EORTC QLQ-C30 Global Health score of the cancer survivors remained low at 53.0 over 100 (SD 21.4). Fifty-four percent of survivors reported at least moderate levels of anxiety, while 27% had at least moderate levels of depression. Late stage at diagnosis was the strongest predictor of low HRQoL. Increasing age, being married, high-income status, hospital type, presence of comorbidities, and chemotherapy administration were also associated with worse HRQoL. The significant predictors of psychological distress were cancer stage and hospital type. CONCLUSION: Cancer survivors in this middle-income setting have persistently impaired HRQoL and high levels of psychological distress. Development of a holistic cancer survivorship program addressing wider aspects of well-being is urgently needed in our settings.
OBJECTIVES: Quality of life and psychological well-being are important patient-centered outcomes, which are useful in evaluation of cancer care delivery. However, evidence from low-income and middle-income countries remains scarce. We assessed health-related quality of life (HRQoL) and prevalence of psychological distress (anxiety or depression), as well as their predictors, among cancer survivors in a middle-income setting. METHODS: Through the Association of Southeast Asian Nations Costs in Oncology study, 1490 newly diagnosed cancerpatients were followed-up in Malaysia for 1 year. Health-related quality of life was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EuroQol-5 (EQ-5D) dimension questionnaires at baseline, 3 and 12 months. Psychological distress was assessed by using Hospital Anxiety and Depression Scale. Data were modeled by using general linear and logistic regressions analyses. RESULTS: One year after diagnosis, the mean EORTC QLQ-C30 Global Health score of the cancer survivors remained low at 53.0 over 100 (SD 21.4). Fifty-four percent of survivors reported at least moderate levels of anxiety, while 27% had at least moderate levels of depression. Late stage at diagnosis was the strongest predictor of low HRQoL. Increasing age, being married, high-income status, hospital type, presence of comorbidities, and chemotherapy administration were also associated with worse HRQoL. The significant predictors of psychological distress were cancer stage and hospital type. CONCLUSION:Cancer survivors in this middle-income setting have persistently impaired HRQoL and high levels of psychological distress. Development of a holistic cancer survivorship program addressing wider aspects of well-being is urgently needed in our settings.
Authors: Syarifah Maisarah Syed Alwi; Vairavan Narayanan; Nur Aishah Mohd Taib; Normah Che Din Journal: Support Care Cancer Date: 2021-11-29 Impact factor: 3.603
Authors: Maria Velia Giulietti; Anna Vespa; Marica Ottaviani; Rossana Berardi; Giancarlo Balercia; Giorgio Arnaldi; Pisana Gattafoni; Paolo Fabbietti; Mirko Di Rosa; Roberta Spatuzzi Journal: Cancer Control Date: 2019 Jan-Dec Impact factor: 3.302