Longitudinal change of quality of life in the first five years of survival among disease-free Chinese breast cancer survivors

Abstract

Purpose

This study aimed to investigate changes of QoL during the first 5 years of survival among disease-free Chinese breast cancer survivors.

Methods

A prospective cohort study enrolled 1462 Chinese women with early-stage breast cancer, and longitudinally visited those patients at four time-points, namely baseline (T0), 18- (T1), 36- (T2), and 60-month (T3) after diagnosis. This study included 992 patients who were disease-free during the first 5 years of survival and who had completed QoL assessments at all four time-points.

Results

The score of global health status/QoL improved gradually (T1, T2, T3 > T0; P < 0.001 for overall comparisons). Social functioning score significantly improved when compared to that of T0 (T1, T2, T3 > T0; P < 0.001 for overall comparisons). In contrast, cognitive functioning score decreased (T0 > T1, T2, T3; P < 0.001 for overall comparisons). Scores of physical functioning, role functioning and emotional functioning showed a fluctuated picture, with the highest score achieved at T1. In symptoms profile, most of them scored lowest at T1 (best QoL). Multivariate analysis showed that several characteristics significantly correlated to changes in QoL from T0 to T3. For instance, patients with higher education had better recovery of physical functioning, role functioning, and social functioning.

Conclusion

During the first 5 years of survival, patients’ global health status/QoL improved over time, social functioning consistently improved, but cognitive functioning steadily deteriorated. Most of functioning domains and symptoms improved at 18-month follow-up, but such improvements were not maintained and even deteriorated at 36- and 60-month post-diagnosis. This study suggested that some interventions should be investigated during such period.

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Fig. 1

Data availability

All analyzed data during the current study were presented in the main manuscript and supplementary file. The original datasets are available from the corresponding author on reasonable request.

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Funding

This work was supported by World Cancer Research Fund International (Grant Number WCRF 2010/249 and WCRF 2014/1197).

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Contributions

YYL, SCH and WY designed the study. TKHL, CK, AC, KLC and RL collected the data. YYL, SCH and WY performed the statistical analyses, interpreted the data and drafted manuscript. All authors approved the final manuscript for publication.

Corresponding author

Correspondence to Winnie Yeo.

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The authors declare no potential conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Joint CUHK-NTEC Clinical Research Ethics Committee and the KWC Research Ethics Committee of the Chinese University of Hong Kong and the Hong Kong Hospital Authority and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written consent was obtained from all individual participants included in the study. The study was approved by the Joint CUHK-NTEC Clinical Research Ethics Committee and the KWC Research Ethics Committee of the Chinese University of Hong Kong and the Hong Kong Hospital Authority.

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Written consent was obtained from all individual participants included in the study.

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Written consent for publication was obtained from all individual participants included in the study.

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Lei, YY., Ho, S.C., Lau, T.K.H. et al. Longitudinal change of quality of life in the first five years of survival among disease-free Chinese breast cancer survivors. Qual Life Res 30, 1583–1594 (2021). https://doi.org/10.1007/s11136-020-02729-6

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Keywords

  • Breast cancer
  • Quality of life
  • The first 5 years of survival
  • Chinese women