496O_PR Health-related quality of life and psychological distress among cancer survivors in a middle-income Asian country

Abstract

Background: Health-related quality of life (HRQoL) is an important outcome in cancer care. Besides being an essential component in assessing the burden of cancer in the population, it may be useful in evaluating national cancer control efforts. Methods: In the ASEAN Cost In Oncology Study, we followed-up 1,362 newly diagnosed cancer patients for one year after diagnosis. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of life Questionnaire Core 30 (QLQ-C30) and EuroQol (EQ-5D). Psychological distress (anxiety and depression) was assessed using the Hospital Anxiety and Depression Scale (HADS). The distribution of HRQoL scores and prevalence of anxiety and depression at 12 months was determined. General linear models and logistic regression analyses were used to identify independent predictors of HRQoL and psychological distress. Results: In the sample, the median age was 52 years; 64% were female. Almost 33% comprised breast cancer patients. One year after diagnosis, the mean EORTC QLQ-C30 Global Health score for survivors was 53 out of 100 (SD 21.3) and the mean index score of EQ-5D was 0.71 (SD 0.18), 83.8% of survivors had anxiety and 79% showed depression. Poorest HRQoL (mean=33.3) and highest prevalence of anxiety (94.0%) and depression (86.7%) were seen in patients with lymphoma, whereas highest HRQol score (mean=67.8) and least psychological distress, anxiety (51.7%); depression (50.6%) were observed in female patients with reproductive system cancers. The most significant predictor of poor HRQol and psychological distress was cancer stage. Psychological distress varied across hospitals and it was significantly higher among those who had radiotherapy. Conclusions: Cancer survivors in Malaysia have low HRQoL and high levels of psychological distress. Supportive interventions addressing wider aspects of wellbeing are urgently needed for cancer survivors.