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Quality of life in “chronic” cancer survivors: a meta-analysis

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Abstract

Purpose

Cancer survivors are now living longer giving rise to a new concept—chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis.

Methods

A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10.

Results

Physical health (CES = − 0.894; CI, − 1.472, − 0.316), role-physical health (CES = − 2.039; CI, − 2.643, − 1.435), and mental health (CES = − 0.870; CI, − 1.447, − 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies.

Conclusion

QOL is significantly impacted 2 to 26 years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors.

Implications for Cancer Survivors

QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.

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Generous funding and support were provided by the ARCS Foundation.

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Authors and Affiliations

  1. Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA

    Jenny Firkins, Lissi Hansen, Martha Driessnack & Nathan Dieckmann

  2. Division of Clinical Psychology, Oregon Health & Science University, 3314 SW US Veterans Hospital Road, Portland, OR, 97239, USA

    Nathan Dieckmann

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  1. Jenny Firkins
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Appendix

Appendix

  • #1 “quality of life” [Mesh] or “health related quality of life” [Mesh]

  • #2 cancer* [Title] or carcinoma* [Title] or malignant* [Title] or neoplasm* [Title]

  • #3 “long term” [Keyword] or “long-term” [Keyword]

  • #4 “2 years” [Keyword] or “more than 2 years” [Keyword] or “greater than 2 years” [Keyword] or “2 years post” [Keyword] or “2 years after” [Keyword]

  • #5 “5 years” [Keyword] or “more than 5 years” [Keyword] or “greater than 5 years” [Keyword] or “5 years post” [Keyword] or “5 years after” [Keyword]

  • #6 “10 years” [Keyword] or “more than 10 years” [Keyword] or “greater than 10 years” [Keyword] or “10 years post” [Keyword] or “10 years after” [Keyword]

  • #7 “15 years” [Keyword] or “more than 15 years” [Keyword] or “greater than 15 years” [Keyword] or “15 years post” [Keyword] or “15 years after” [Keyword]

  • #8 “20 years” [Keyword] or “more than 20 years” [Keyword] or “greater than 20 years” [Keyword] or “20 years post” [Keyword] or “20 years after” [Keyword]

  • #9 (#4 #5 #6 #7 or #8)

  • #10 (#1 #2 #3 and #9)

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Firkins, J., Hansen, L., Driessnack, M. et al. Quality of life in “chronic” cancer survivors: a meta-analysis. J Cancer Surviv 14, 504–517 (2020). https://doi.org/10.1007/s11764-020-00869-9

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