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Health-related quality of life among elderly breast cancer patients treated with adjuvant endocrine therapy: a U.S Medicare population-based study

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Abstract

Objectives

The evidence regarding the impact of individual adjuvant endocrine therapies (AET) on health-related quality of life (HRQoL) is limited. We aimed to assess the association between the type of AET and HRQoL and to examine the relationship between HRQoL and one-year mortality among women with breast cancer in the USA.

Methods

This retrospective cross-sectional study used the 2006–2017 Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey database to identify older women with early-stage hormone receptor-positive breast cancer. Multivariate linear regressions were used to assess the association between types of AET (anastrozole, letrozole, exemestane, and tamoxifen) and HRQoL scores (physical component summary (PCS) and mental component summary (MCS)). Multivariate logistic regressions were used to predict the impact of PCS and MCS on one-year mortality.

Results

Out of 3537 older women with breast cancer, anastrozole was the most commonly prescribed (n = 1945, 55.0%). Regarding PCS, there was no significant difference between the four AET agents. Higher MCS scores, which indicate better HRQoL, were reported in patients treated with anastrozole (vs. letrozole [β = 1.26, p = 0.007] and exemestane [β = 2.62, p = 0.005) and tamoxifen (vs. letrozole [β = 1.49, p = 0.010] and exemestane [β = 2.85, p = 0.004]). Lower PCS and MCS scores were associated with higher one-year mortality, regardless of type of AET initiated, except for tamoxifen in MCS.

Conclusion

Although there was no significant difference in physical HRQoL scores between AET agents, anastrozole and tamoxifen were associated with better mental HRQoL scores.

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Acknowledgements

This study used data from the SEER-MHOS linked data resource. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; the Centers for Medicare & Medicaid Services; Information Management Services (IMS), Inc.; and the SEER Program tumor registries in the creation of the SEER-MHOS database.

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Authors and Affiliations

  1. Health Outcome Division, The University of Texas at Austin College of Pharmacy, 2409 University Avenue MC A1930, Austin, TX, 78712-1120, USA

    Chanhyun Park

  2. School of Pharmacy, The Catholic University of Korea, Bucheon, South Korea

    Sun-Kyeong Park

  3. Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, Boston, MA, USA

    Ahye Woo

  4. College of Nursing, University of Central Florida, Orlando, FL, USA

    Boon Peng Ng

  5. Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA

    Boon Peng Ng

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  1. Chanhyun Park
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All authors have reviewed and approved the content and have contributed significantly to the work.

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Correspondence to Chanhyun Park.

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All the authors declare that they have no conflict of interest.

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As a secondary data analysis of the SEER-MHOS database with de-identified data, approval from Northeastern University Institutional Review Board (IRB) was obtained before accessing the data from the National Cancer Institute (NCI).

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All authors have reviewed and approved the content and have contributed significantly to the work.

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Park, C., Park, SK., Woo, A. et al. Health-related quality of life among elderly breast cancer patients treated with adjuvant endocrine therapy: a U.S Medicare population-based study. Qual Life Res 31, 1345–1357 (2022). https://doi.org/10.1007/s11136-021-03059-x

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