Skip to main content

Advertisement

SpringerLink
Log in

Healthcare services and medication use among cancer survivors and their partners: a cross-sectional analysis of 16 European countries

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

To estimate the association between a cancer diagnosis and the use of healthcare services and medication among cancer survivors (CS) and their partners (PCS), particularly in the first years after diagnosis.

Methods

This is a cross-sectional study based on data from the Fourth Wave of the Survey of Health, Ageing and Retirement in Europe—SHARE (2010–2011); it included individuals aged ≥ 50 years and their partners, from 16 European countries. All CS diagnosed with a first primary cancer within 10 years (n = 1174) and corresponding PCS (n = 1174) were country-, sex-, age- and education-matched (1:3) with non-cancer individuals (NC) and partners of non-cancer individuals (PNC), respectively. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were computed.

Results

Healthcare use in the previous 12 months and current medication intake were more frequent among CS than NC; the ORs (95% CIs) were 2.56 (2.23–2.94) for ≥ 8 medical contacts, 3.07 (2.62–3.59) for hospital stays and 1.75 (1.52–2.03) for use of ≥ 3 drugs indicated for different health problems. Medical contacts (OR = 5.74, 95% CI 4.31–7.65) and hospitals stays (OR = 13.88, 95% CI 10.15–18.98) were more frequent among CS diagnosed in the last 2 years. Contacts with medical doctors (≥ 8; OR = 1.23, 95% CI 1.06–1.42) were also more common among PCS than PNC.

Conclusion

When compared to individuals without cancer, CS diagnosed in the last 10 years, as well as their partners, had an increased healthcare use.

Implication for Cancer Survivors

These findings highlight the importance of family-focused care in oncological settings, in order to support patients as well as their partners, who are frequently their closest significant person.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ferlay J, Colombet M, Bray F. Cancer incidence in five continents, CI5plus: IARC CancerBase no. 9 [internet]. International Agency for Research on Cancer: Lyon, France; 2018. Available from: http://ci5.iarc.fr. Accessed 15 May 2019

  2. UN Population Division. World population prospects: the 2012 revision - vol I, comprehensive tables (ST/ESA/SER.A/336). New York: UN Department of Economic and Social Affairs; 2013.

    Google Scholar 

  3. Araujo F, Gouvinhas C, Fontes F, La Vecchia C, Azevedo A, Lunet N. Trends in cardiovascular diseases and cancer mortality in 45 countries from five continents (1980-2010). Eur J Prev Cardiol. 2013;21(8):1004–17.

    Article  Google Scholar 

  4. Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012;367(21):1998–2005.

    Article  CAS  Google Scholar 

  5. Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Niksic M, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023–75.

    Article  Google Scholar 

  6. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global cancer observatory: cancer today. International Agency for Research on Cancer: Lyon, France; 2018. Available from: https://gco.iarc.fr/today. Accessed 15 May 2019

  7. Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. Committee on Cancer Survivorship: improving care and quality of life. Institute of Medicine and National Research Council, editor. Washington, DC: National Academies Press; 2006.

  8. Kim Y, Shaffer KM, Carver CS, Cannady RS. Quality of life of family caregivers 8 years after a relative’s cancer diagnosis: follow-up of the National Quality of Life Survey for Caregivers. Psychooncology. 2016;25(3):266–74.

    Article  Google Scholar 

  9. Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P. Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. Lancet Oncol. 2013;14(8):721–32.

    Article  Google Scholar 

  10. Hawkins NA, Soman A, Buchanan Lunsford N, Leadbetter S, Rodriguez JL. Use of medications for treating anxiety and depression in cancer survivors in the United States. J Clin Oncol. 2017;35(1):78–85.

    Article  Google Scholar 

  11. Jansson MRN, von Heymann-Horan A, Rasmussen BK, Albieri V, Frederiksen K, Suppli N, et al. Risk for use of antidepressants, anxiolytics, and hypnotics in partners of glioma patients-a nationwide study covering 19 years of prescriptions. Psychooncology. 2018;27(8):1930–6.

    Article  Google Scholar 

  12. Stein KD, Syrjala KL, Andrykowski MA. Physical and psychological long-term and late effects of cancer. Cancer. 2008;112(11 Suppl):2577–92.

    Article  Google Scholar 

  13. Goren A, Gilloteau I, Lees M, DaCosta Dibonaventura M. Quantifying the burden of informal caregiving for patients with cancer in Europe. Support Care Cancer. 2014;22(6):1637–46.

    Article  Google Scholar 

  14. Huang IC, Hudson MM, Robison LL, Krull KR. Differential impact of symptom prevalence and chronic conditions on quality of life in cancer survivors and non-cancer individuals: a population study. Cancer Epidemiol Biomark Prev. 2017;26(7):1124–32.

    Article  Google Scholar 

  15. Heins M, Schellevis F, Rijken M, van der Hoek L, Korevaar J. Determinants of increased primary health care use in cancer survivors. J Clin Oncol. 2012;30(33):4155–60.

    Article  Google Scholar 

  16. Pacheco-Figueiredo L, Lunet N. Health status, use of healthcare, and socio-economic implications of cancer survivorship in Portugal: results from the Fourth National Health Survey. J Cancer Surviv. 2014;8(4):611–7.

    Article  Google Scholar 

  17. Heins M, Schellevis F, Rijken M, Donker G, van der Hoek L, Korevaar J. Partners of cancer patients consult their GPs significantly more often with both somatic and psychosocial problems. Scand J Prim Health Care. 2013;31(4):203–8.

    Article  Google Scholar 

  18. Sjovall K, Attner B, Lithman T, Noreen D, Gunnars B, Thome B, et al. Influence on the health of the partner affected by tumor disease in the wife or husband based on a population-based register study of cancer in Sweden. J Clin Oncol. 2009;27(28):4781–6.

    Article  Google Scholar 

  19. Mollerberg ML, Sandgren A, Lithman T, Noreen D, Olsson H, Sjovall K. The effects of a cancer diagnosis on the health of a patient’s partner: a population-based registry study of cancer in Sweden. Eur J Cancer Care (Engl). 2016;25(5):744–52.

    Article  Google Scholar 

  20. Ekwueme DU, Yabroff KR, Guy GP Jr, Banegas MP, de Moor JS, Li C, et al. Medical costs and productivity losses of cancer survivors--United States, 2008-2011. MMWR Morb Mortal Wkly Rep. 2014;63(23):505–10.

    PubMed  PubMed Central  Google Scholar 

  21. Maddams J, Utley M, Moller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer. 2012;107(7):1195–202.

    Article  CAS  Google Scholar 

  22. Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69(5):363–85.

    Article  Google Scholar 

  23. Borsch-Supan A, Brandt M, Hunkler C, Kneip T, Korbmacher J, Malter F, et al. Data resource profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). Int J Epidemiol. 2013;42(4):992–1001.

    Article  Google Scholar 

  24. Bergmann M, Kneip T, De Luca G, Scherpenzeel A. Survey participation in the Survey of Health, Ageing and Retirement in Europe (SHARE), Wave 1-6. Based on Release 6.0.0 (March 2017). Munich: Munich Center for the Economics of Aging (MEA); 2017.

    Google Scholar 

  25. SHARE Wave 4: innovations & methodology. Malter F, Börsch-Supan A, editors. Munich: MEA, Max Planck Institute for Social Law and Social Policy; 2013.

  26. United Nations Educational Scientific and Cultural Organization. International standard classification of education (ISCED-1997) - re-edition. Montreal: UNESCO-UIS; 2006.

    Google Scholar 

  27. National Coalition for Cancer Survivorship. History of NCCS 2019 [Available from: https://www.canceradvocacy.org/about-us/our-history/]. Accessed 1 March 2020

  28. De Angelis R, Sant M, Coleman MP, Francisci S, Baili P, Pierannunzio D, et al. Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE--5-a population-based study. Lancet Oncol. 2014;15(1):23–34.

    Article  Google Scholar 

  29. Prince MJ, Reischies F, Beekman AT, Fuhrer R, Jonker C, Kivela SL, et al. Development of the EURO-D scale--a European, union initiative to compare symptoms of depression in 14 European centres. Br J Psychiatry. 1999;174:330–8.

    Article  CAS  Google Scholar 

  30. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893–7.

    Article  CAS  Google Scholar 

  31. Heins MJ, Korevaar JC, Rijken PM, Schellevis FG. For which health problems do cancer survivors visit their general practitioner? Eur J Cancer. 2013;49(1):211–8.

    Article  CAS  Google Scholar 

  32. Travis LB. The epidemiology of second primary cancers. Cancer Epidemiol Biomark Prev. 2006;15(11):2020–6.

    Article  Google Scholar 

  33. Moser RP, Arndt J, Han PK, Waters EA, Amsellem M, Hesse BW. Perceptions of cancer as a death sentence: prevalence and consequences. J Health Psychol. 2014;19(12):1518–24.

    Article  Google Scholar 

  34. Lebel S, Tomei C, Feldstain A, Beattie S, McCallum M. Does fear of cancer recurrence predict cancer survivors’ health care use? Support Care Cancer. 2013;21(3):901–6.

    Article  Google Scholar 

  35. Given BA, Given CW, Kozachik S. Family support in advanced cancer. CA Cancer J Clin. 2001;51(4):213–31.

    Article  CAS  Google Scholar 

  36. Luppa M, Sikorski C, Motzek T, Konnopka A, Konig HH, Riedel-Heller SG. Health service utilization and costs of depressive symptoms in late life - a systematic review. Curr Pharm Des. 2012;18(36):5936–57.

    Article  CAS  Google Scholar 

  37. Northouse L, Williams AL, Given B, McCorkle R. Psychosocial care for family caregivers of patients with cancer. J Clin Oncol. 2012;30(11):1227–34.

    Article  Google Scholar 

  38. Williams AL. Psychosocial burden of family caregivers to adults with cancer. Recent Results Cancer Res. 2014;197:73–85.

    Article  Google Scholar 

  39. Northouse LL, Mood DW, Montie JE, Sandler HM, Forman JD, Hussain M, et al. Living with prostate cancer: patients’ and spouses’ psychosocial status and quality of life. J Clin Oncol. 2007;25(27):4171–7.

    Article  Google Scholar 

  40. Bergmann MM, Calle EE, Mervis CA, Miracle-McMahill HL, Thun MJ, Heath CW. Validity of self-reported cancers in a prospective cohort study in comparison with data from state cancer registries. Am J Epidemiol. 1998;147(6):556–62.

    Article  CAS  Google Scholar 

  41. Navarro C, Chirlaque MD, Tormo MJ, Perez-Flores D, Rodriguez-Barranco M, Sanchez-Villegas A, et al. Validity of self reported diagnoses of cancer in a major Spanish prospective cohort study. J Epidemiol Community Health. 2006;60(7):593–9.

    Article  CAS  Google Scholar 

  42. Ritter PL, Stewart AL, Kaymaz H, Sobel DS, Block DA, Lorig KR. Self-reports of health care utilization compared to provider records. J Clin Epidemiol. 2001;54(2):136–41.

    Article  CAS  Google Scholar 

  43. Wallihan DB, Stump TE, Callahan CM. Accuracy of self-reported health services use and patterns of care among urban older adults. Med Care. 1999;37(7):662–70.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982) and Horizon 2020 (SHARE-DEV3: GA N°676536, SERISS: GA N°654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see www.share-project.org).

Funding

This study was funded by national funding from the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education), under the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (UIDB/04750/2020). An individual PhD grant attributed to ARC (SFRH/BD/102181/2014) was co-funded by FCT and the Programa Operacional Capital Humano (POCH/FSE).

Author information

Authors and Affiliations

  1. EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas no. 135, 4050-600, Porto, Portugal

    Ana Rute Costa & Nuno Lunet

  2. Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Rua de Jorge Viterbo Ferreira no. 228, 4050-313, Porto, Portugal

    Luís Alves

  3. USF St. André de Canidelo, ACES Grande Porto Gaia VII, ARS Norte, R. das Fábricas 282, 4400-712, Vila Nova de Gaia, Portugal

    Luís Alves

  4. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal

    Nuno Lunet

Authors
  1. Ana Rute Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luís Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nuno Lunet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nuno Lunet.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Ethics Committee at the University of Mannheim approved Waves 1 to 4. The Fourth Wave was approved by the Ethics Council of the Max-Planck-Society. Additionally, whenever required, the implementation of SHARE in each country was approved by the respective ethics committees or institutional review boards.

Informed consent

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

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 34 kb).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Costa, A.R., Alves, L. & Lunet, N. Healthcare services and medication use among cancer survivors and their partners: a cross-sectional analysis of 16 European countries. J Cancer Surviv 14, 720–730 (2020). https://doi.org/10.1007/s11764-020-00886-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-020-00886-8

Keywords

Search

Navigation