Quality of Life Research

, Volume 26, Issue 7, pp 1703–1712 | Cite as

The prognostic value of pre-diagnosis health-related quality of life on survival: a prospective cohort study of older Americans with lung cancer

  • Laura C. Pinheiro
  • Timothy M. Zagar
  • Bryce B. Reeve
Article

Abstract

Purpose

Health-related quality of life (HRQOL) after cancer diagnosis is prognostic for overall survival (OS). However, no studies have assessed if HRQOL before diagnosis is predictive for OS. The objective of this study was to determine the association between pre-lung cancer diagnosis HRQOL and OS.

Methods

Our prospective cohort study used surveillance, epidemiology, and end results linked to the Medicare Health Outcomes Survey. We included 6290 individuals 65 years or older diagnosed with incident lung cancer from 1998 to 2013. We assessed the prognostic value of (1) short-form 36 summary component and domain-specific scores, (2) activities of daily living (ADL), and (3) two global HRQOL questions. Cox-proportional hazards models were used to examine associations between HRQOL and OS, adjusting for demographics, comorbid conditions, and clinical characteristics.

Results

Worse pre-diagnosis HRQOL was significantly associated with greater risk of death across HRQOL measures. An above average physical or mental component summary score was associated with 16 and 24% decreases in the hazard of death, respectively (p < 0.0001). Being unable to perform ADLs, such as bathing oneself, was associated with an 89% increased hazard of death (p < 0.0001). Reporting “poor” versus “excellent” health was associated with a 74% increase in the hazard of death (p < 0.0001).

Conclusion

This population-based study reinforces the importance of self-reported health status as a predictor for OS. Routine HRQOL screening may identify patients who could benefit from early interventions to improve HRQOL. Future studies should explore associations between changes in HRQOL before and after cancer diagnosis and OS.

Keywords

Quality of life Survival Lung cancer 

Notes

Acknowledgements

This study was supported by the University Cancer Research Fund of North Carolina and the National Cancer Institute’s Research Supplement to Promote Diversity in Health Research.

Compliance with ethical standards

Conflict of interest

All other authors (Dr. Pinheiro, Dr. Zagar, and Dr. Reeve) declare that they have no conflicts of interest to disclose.

Informed consent

Informed consent from study subjects was not needed as the University of North Carolina at Chapel Hill IRB granted this research exemption from review.

References

  1. 1.
    Ferlay, J., Shin, H. R., Bray, F., Forman, D., Mathers, C., & Parkin, D. M. (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International Journal of Cancer Journal International du Cancer, 127(12), 2893–2917. doi: 10.1002/ijc.25516.CrossRefPubMedGoogle Scholar
  2. 2.
    Claassens, L., van Meerbeeck, J., Coens, C., Quinten, C., Ghislain, I., Sloan, E. K., Wang, X. S., Velikova, G., & Bottomley, A. (2011). Health-related quality of life in non-small-cell lung cancer: an update of a systematic review on methodologic issues in randomized controlled trials. Journal of Clinical Oncology, 29(15), 2104–2120. doi: 10.1200/jco.2010.32.3683.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Akin, S., Can, G., Aydiner, A., Ozdilli, K., & Durna, Z. (2010). Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy. European Journal of Oncology Nursing, 14(5), 400–409. doi: 10.1016/j.ejon.2010.01.003.CrossRefPubMedGoogle Scholar
  4. 4.
    Ediebah, D. E., Coens, C., Zikos, E., Quinten, C., Ringash, J., King, M. T., Schmucker von Koch, J., Gotay, C., Greimel, E., Flechtner, H., Weis, J., Reeve, B. B., Smit, E. F., Taphoorn, M. J., & Bottomley, A. (2014). Does change in health-related quality of life score predict survival? Analysis of EORTC 08975 lung cancer trial. British Journal of Cancer, 110(10), 2427–2433. doi: 10.1038/bjc.2014.208.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Hennessy CH, Moriarty DG, Zack MM, Scherr PA, Brackbill R (1994) Measuring health-related quality of life for public health surveillance. Public health reports (Washington, DC, 1974) 109(5):665–672.Google Scholar
  6. 6.
    Lopez-Class, M., Perret-Gentil, M., Kreling, B., Caicedo, L., Mandelblatt, J., & Graves, K. D. (2011). Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care. Journal of Cancer Education, 26(4), 724–733. doi: 10.1007/s13187-011-0249-4.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Donovan, K., Sanson-Fisher, R. W., & Redman, S. (1989). Measuring quality of life in cancer patients. Journal of Clinical Oncology, 7(7), 959–968. doi: 10.1200/jco.1989.7.7.959.CrossRefPubMedGoogle Scholar
  8. 8.
    Gotay, C. C., Kawamoto, C. T., Bottomley, A., & Efficace, F. (2008). The prognostic significance of patient-reported outcomes in cancer clinical trials. Journal of Clinical Oncology, 26(8), 1355–1363. doi: 10.1200/jco.2007.13.3439.CrossRefPubMedGoogle Scholar
  9. 9.
    Singh, J. A., Nelson, D. B., Fink, H. A., & Nichol, K. L. (2005). Health-related quality of life predicts future health care utilization and mortality in veterans with self-reported physician-diagnosed arthritis: the veterans arthritis quality of life study. Seminars in Arthritis and Rheumatism, 34(5), 755–765. doi: 10.1016/j.semarthrit.2004.08.001.CrossRefPubMedGoogle Scholar
  10. 10.
    Cunningham, W. E., Crystal, S., Bozzette, S., & Hays, R. D. (2005). The association of health-related quality of life with survival among persons with HIV infection in the United States. Journal of General Internal Medicine, 20(1), 21–27. doi: 10.1111/j.1525-1497.2005.30402.x.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Sloan, J. A., Zhao, X., Novotny, P. J., Wampfler, J., Garces, Y., Clark, M. M., & Yang, P. (2012). Relationship between deficits in overall quality of life and non-small-cell lung cancer survival. Journal of Clinical Oncology, 30(13), 1498–1504. doi: 10.1200/jco.2010.33.4631.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Cooley, M. E. (2000). Symptoms in adults with lung cancer. A systematic research review. Journal of Pain and Symptom Management, 19(2), 137–153.CrossRefPubMedGoogle Scholar
  13. 13.
    Ganz, P. A., Lee, J. J., & Siau, J. (1991). Quality of life assessment. An independent prognostic variable for survival in lung cancer. Cancer, 67(12), 3131–3135.CrossRefPubMedGoogle Scholar
  14. 14.
    Eton, D. T., Fairclough, D. L., Cella, D., Yount, S. E., Bonomi, P., & Johnson, D. H. (2003). Early change in patient-reported health during lung cancer chemotherapy predicts clinical outcomes beyond those predicted by baseline report: results from Eastern Cooperative Oncology Group Study 5592. Journal of Clinical Oncology, 21(8), 1536–1543. doi: 10.1200/jco.2003.07.128.CrossRefPubMedGoogle Scholar
  15. 15.
    Efficace, F., Bottomley, A., Smit, E. F., Lianes, P., Legrand, C., Debruyne, C., Schramel, F., Smit, H. J., Gaafar, R., Biesma, B., Manegold, C., Coens, C., Giaccone, G., & Van Meerbeeck, J. (2006). Is a patient’s self-reported health-related quality of life a prognostic factor for survival in non-small-cell lung cancer patients? A multivariate analysis of prognostic factors of EORTC study 08975. Annals of Oncology, 17(11), 1698–1704. doi: 10.1093/annonc/mdl183.CrossRefPubMedGoogle Scholar
  16. 16.
    Maione, P., Perrone, F., Gallo, C., Manzione, L., Piantedosi, F., Barbera, S., Cigolari, S., Rosetti, F., Piazza, E., Robbiati, S. F., Bertetto, O., Novello, S., Migliorino, M. R., Favaretto, A., Spatafora, M., Ferrau, F., Frontini, L., Bearz, A., Repetto, L., Gridelli, C., Barletta, E., Barzelloni, M. L., Iaffaioli, R. V., De Maio, E., Di Maio, M., De Feo, G., Sigoriello, G., Chiodini, P., Cioffi, A., Guardasole, V., Angelini, V., Rossi, A., Bilancia, D., Germano, D., Lamberti, A., Pontillo, V., Brancaccio, L., Renda, F., Romano, F., Esani, G., Gambaro, A., Vinante, O., Azzarello, G., Clerici, M., Bollina, R., Belloni, P., Sannicolo, M., Ciuffreda, L., Parello, G., Cabiddu, M., Sacco, C., Sibau, A., Porcile, G., Castiglione, F., Ostellino, O., Monfardini, S., Stefani, M., Scagliotti, G., Selvaggi, G., De Marinis, F., Martelli, O., Gasparini, G., Morabito, A., Gattuso, D., Colucci, G., Galetta, D., Giotta, F., Gebbia, V., Borsellino, N., Testa, A., Malaponte, E., Capuano, M. A., Angiolillo, M., Sollitto, F., Tirelli, U., Spazzapan, S., Adamo, V., Altavilla, G., Scimone, A., Hopps, M. R., Tartamella, F., Ianniello, G. P., Tinessa, V., Failla, G., Bordonaro, R., Gebbia, N., Valerio, M. R., D’Aprile, M., Veltri, E., Tonato, M., Darwish, S., Romito, S., Carrozza, F., Barni, S., Ardizzoia, A., Corradini, G. M., Pavia, G., Belli, M., Colantuoni, G., Galligioni, E., Caffo, O., Labianca, R., Quadri, A., Cortesi, E., D’Auria, G., Fava, S., Calcagno, A., Luporini, G., Locatelli, M. C., Di Costanzo, F., Gasperoni, S., Isa, L., Candido, P., Gaion, F., Palazzolo, G., Nettis, G., Annamaria, A., Rinaldi, M., Lopez, M., Felletti, R., Di Negro, G. B., Rossi, N., Calandriello, A., Maiorino, L., Mattioli, R., Celano, A., Schiavon, S., Illiano, A., Raucci, C. A., Caruso, M., Foa, P., Tonini, G., Curcio, C., & Cazzaniga, M. (2005). Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study. Journal of Clinical Oncology, 23(28), 6865–6872. doi: 10.1200/jco.2005.02.527.CrossRefPubMedGoogle Scholar
  17. 17.
    Reeve, B. B., Potosky, A. L., Smith, A. W., Han, P. K., Hays, R. D., Davis, W. W., Arora, N. K., Haffer, S. C., & Clauser, S. B. (2009). Impact of cancer on health-related quality of life of older Americans. Journal of the National Cancer Institute, 101(12), 860–868. doi: 10.1093/jnci/djp123.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Ambs, A., Warren, J. L., Bellizzi, K. M., Topor, M., Haffer, S. C., & Clauser, S. B. (2008). Overview of the SEER–Medicare Health Outcomes Survey linked dataset. Health Care Financing Review, 29(4), 5–21.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Ware, J. E. Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.CrossRefPubMedGoogle Scholar
  20. 20.
    Fleishman, J. A., Selim, A. J., & Kazis, L. E. (2010). Deriving SF-12v2 physical and mental health summary scores: a comparison of different scoring algorithms. Quality of Life Research, 19(2), 231–241. doi: 10.1007/s11136-009-9582-z.CrossRefPubMedGoogle Scholar
  21. 21.
    Selim AR, W; Qian, S; Rothendler, JA; Kent, EE; Kazis, LE. (2016) A new algorithm to build bridges between two patient-reported health outcome instruments: the MOS SF-36® and the VR-12 health survey. National Cancer Institute.Google Scholar
  22. 22.
    Pinheiro, L. C., Wheeler, S. B., Chen, R. C., Mayer, D. K., Lyons, J. C., & Reeve, B. B. (2015). The effects of cancer and racial disparities in health-related quality of life among older Americans: a case-control, population-based study. Cancer, 121(8), 1312–1320. doi: 10.1002/cncr.29205.CrossRefPubMedGoogle Scholar
  23. 23.
    Angst, F., Aeschlimann, A., & Stucki, G. (2001). Smallest detectable and minimal clinically important differences of rehabilitation intervention with their implications for required sample sizes using WOMAC and SF-36 quality of life measurement instruments in patients with osteoarthritis of the lower extremities. Arthritis and Rheumatism, 45(4), 384–391. doi: 10.1002/1529-0131(200108)45:4<384::aid-art352>3.0.co;2-0.CrossRefPubMedGoogle Scholar
  24. 24.
    Swigris, J. J., Brown, K. K., Behr, J., du Bois, R. M., King, T. E., Raghu, G., & Wamboldt, F. S. (2010). The SF-36 and SGRQ: validity and first look at minimum important differences in IPF. Respiratory Medicine, 104(2), 296–304. doi: 10.1016/j.rmed.2009.09.006.CrossRefPubMedGoogle Scholar
  25. 25.
    Bjorner, J. B., Wallenstein, G. V., Martin, M. C., Lin, P., Blaisdell-Gross, B., Tak Piech, C., & Mody, S. H. (2007). Interpreting score differences in the SF-36 Vitality scale: using clinical conditions and functional outcomes to define the minimally important difference. Current Medical Research and Opinion, 23(4), 731–739. doi: 10.1185/030079907x178757.CrossRefPubMedGoogle Scholar
  26. 26.
    Cohen, J. (1965). Some statistical issues in psychological research. In Handbook of clinical psychology (pp. 95–121). New York: McGraw-Hill.Google Scholar
  27. 27.
    Pompili, C., Salati, M., Refai, M., Berardi, R., Onofri, A., Mazzanti, P., & Brunelli, A. (2013). Preoperative quality of life predicts survival following pulmonary resection in stage I non-small-cell lung cancer. European Journal of Cardio-thoracic Surgery, 43(5), 905–910. doi: 10.1093/ejcts/ezs532.CrossRefPubMedGoogle Scholar
  28. 28.
    Moller, A., & Sartipy, U. (2012). Quality of life six months after lung cancer surgery is associated with long-term survival. Acta Oncologica (Stockholm, Sweden), 51(8), 1029–1035. doi: 10.3109/0284186x.2012.689112.CrossRefGoogle Scholar
  29. 29.
    Katz, S. (1983). Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. Journal of the American Geriatrics Society, 31(12), 721–727.CrossRefPubMedGoogle Scholar
  30. 30.
    Reeve, B. B., Stover, A. M., Jensen, R. E., Chen, R. C., Taylor, K. L., Clauser, S. B., Collins, S. P., & Potosky, A. L. (2012). Impact of diagnosis and treatment of clinically localized prostate cancer on health-related quality of life for older Americans: a population-based study. Cancer, 118(22), 5679–5687. doi: 10.1002/cncr.27578.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Stover, A. M., Mayer, D. K., Muss, H., Wheeler, S. B., Lyons, J. C., & Reeve, B. B. (2014). Quality of life changes during the pre- to postdiagnosis period and treatment-related recovery time in older women with breast cancer. Cancer, 120(12), 1881–1889. doi: 10.1002/cncr.28649.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Concato, J., Peduzzi, P., Holford, T. R., & Feinstein, A. R. (1995). Importance of events per independent variable in proportional hazards analysis. I. Background, goals, and general strategy. Journal of Clinical Epidemiology, 48(12), 1495–1501.CrossRefPubMedGoogle Scholar
  33. 33.
    Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3), 179–186.CrossRefPubMedGoogle Scholar
  34. 34.
    Jensen, G. A., & Morrisey, M. A. (2004). Are healthier older adults choosing managed care? The Gerontologist, 44(1), 85–94.CrossRefPubMedGoogle Scholar
  35. 35.
    Morgan, R. O., Virnig, B. A., DeVito, C. A., & Persily, N. A. (1997). The Medicare-HMO revolving door–the healthy go in and the sick go out. The New England Journal of Medicine, 337(3), 169–175. doi: 10.1056/nejm199707173370306.CrossRefPubMedGoogle Scholar
  36. 36.
    Pourat, N., Kagawa-Singer, M., & Wallace, S. P. (2006). Are managed care Medicare beneficiaries with chronic conditions satisfied with their care? Journal of Aging and Health, 18(1), 70–90.CrossRefPubMedGoogle Scholar
  37. 37.
    Jagsi, R., Abrahamse, P., Hawley, S. T., Graff, J. J., Hamilton, A. S., & Katz, S. J. (2012). Underascertainment of radiotherapy receipt in surveillance, epidemiology, and end results registry data. Cancer, 118(2), 333–341. doi: 10.1002/cncr.26295.CrossRefPubMedGoogle Scholar
  38. 38.
    Santana, M. J., & Feeny, D. H. (2009). Using the health utilities index in routine clinical care: process, feasibility, and acceptability: a randomized controlled trial. The patient, 2(3), 159–167. doi: 10.2165/11313620-000000000-00000.CrossRefPubMedGoogle Scholar
  39. 39.
    Detmar, S. B., Muller, M. J., Schornagel, J. H., Wever, L. D., & Aaronson, N. K. (2002). Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial. JAMA, 288(23), 3027–3034.CrossRefPubMedGoogle Scholar
  40. 40.
    Taenzer, P., Bultz, B. D., Carlson, L. E., Speca, M., DeGagne, T., Olson, K., Doll, R., & Rosberger, Z. (2000). Impact of computerized quality of life screening on physician behaviour and patient satisfaction in lung cancer outpatients. Psycho-oncology, 9(3), 203–213.CrossRefPubMedGoogle Scholar
  41. 41.
    Velikova, G., Wright, E. P., Smith, A. B., Cull, A., Gould, A., Forman, D., Perren, T., Stead, M., Brown, J., & Selby, P. J. (1999). Automated collection of quality-of-life data: a comparison of paper and computer touch-screen questionnaires. Journal of Clinical Oncology, 17(3), 998–1007.CrossRefPubMedGoogle Scholar
  42. 42.
    Wagner, A. K., Ehrenberg, B. L., Tran, T. A., Bungay, K. M., Cynn, D. J., & Rogers, W. H. (1997). Patient-based health status measurement in clinical practice: a study of its impact on epilepsy patients’ care. Quality of Life Research, 6(4), 329–341.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Laura C. Pinheiro
    • 1
  • Timothy M. Zagar
    • 2
  • Bryce B. Reeve
    • 1
    • 3
  1. 1.Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Departments of Neurosurgery and Radiation OncologyUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of Health Policy and Management, Gillings School of Global Public Health,Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA

Personalised recommendations