Differential impact of symptom prevalence and chronic conditions on quality of life in cancer survivors and non-cancer individuals: A population study

Abstract

Background: To compare associations of symptom prevalence, chronic conditions, and health-related quality of life (HRQOL) between cancer survivors and non-cancer individuals using the U.S. National Health Interview Survey. Methods: Study samples comprised 604 survivors and 6,166 non-cancer individuals. Symptoms included sensation abnormality, pain, fatigue, cognitive disturbance, depression, and anxiety. Physical and mental HRQOL was measured by the Patient-Reported Outcomes Measurement Information System. Results: Compared with non-cancer individuals, survivors had higher prevalence in sensation abnormality (OR 2.4; 95% CI 1.9 to 3.0), pain (OR 2.1; 95% CI 1.7 to 2.6), fatigue (OR 1.4; 95% CI 1.1 to 1.8), and decremented physical HRQOL (difference 3.7; 95% CI 4.7 to 2.6). The prevalence of individual symptoms was significantly associated with decremented physical HRQOL [range5.9 (anxiety) to 8.9 (pain)] and mental HRQOL [range4.7 (sensation) to 8.4 (depression)]. The association between cancer experience and physical and mental HRQOL was chiefly explained by the prevalence of six symptoms and presence of chronic conditions. Pain (b 4.0; 95% CI 4.5 to 3.6) and 2 chronic conditions (b 9.2; 95% CI 10.2 to 8.2) significantly decremented physical HRQOL. Depression (b5.2; 95% CI5.8 to 4.6) and 2 chronic conditions (b 3.3; 95% CI 4.4 to 2.3) significantly decremented mental HRQOL. Conclusions: Cancer survivors experience more symptom burden than non-cancer individuals, which is associated with more chronic conditions and impaired HRQOL. Impacts: Interventions to manage symptom prevalence especially for older cancer survivors and survivors with more chronic conditions may improve their HRQOL outcomes.