Skip to main content

Advertisement

SpringerLink
Log in

Comparison of physical and mental health status between cancer survivors and the general population: a Korean population-based survey (KNHANES II-IV)

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

To compare the physical and mental health status of the general population with that of cancer survivors in South Korea.

Methods

We analyzed 19,035 subjects (age ≥40 years), who participated in the 2001–2009 Korea National Health and Nutrition Examination Survey II–IV. We compared metabolic syndrome components, health behaviors, and mental health outcomes between cancer survivors and non-cancer controls.

Results

Cancer survivors accounted for 1.68 % (n = 316) of total population. Cancer survivors did not show low occurrence of hypertension and diabetes compared to the control group. Both cancer survivors and the general population had high risks of physical inactivity (75.4 % and 75.5 %, respectively) and inadequate sleep (52.5 % and 60.7 %, respectively). In the unadjusted model, depression was more common in cancer survivors (odds ratio [OR], 1.61; 95 % CI, 1.22–2.74), so was suicidal ideation (OR, 1.51; 95 % CI, 0.16–1.96) than non-cancer controls. After adjustment for attributable socioeconomic factors, the elevated adjusted odds ratios (aORs) among cancer survivors were reduced by 23 % in depression and 45 % in suicidal thought. Cancer survivors at <5 years from diagnosis showed a high occurrence of depression (aOR, 1.77; 95 % CI, 1.09–2.85) while the magnitude of aOR decreases after ≥5 years from cancer diagnosis (aOR, 1.38; 95 % confidence interval, 0.97–1.98, respectively).

Conclusions

The physical and mental health of South Korean cancer survivors was not optimal. Their control rates of modifiable risk factors were similar or even lower than those for the non-cancer groups. Depression was highly prevalent in cancer survivors which can be ascribed, at least in part, to socioeconomic environment. A better-targeted intervention to improve the health of this population may be needed.

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

Similar content being viewed by others

References

  1. Ahn E, Shin DW, Cho SI, Park S, Won YJ, Yun YH (2010) Suicide rates and risk factors among Korean cancer patients, 1993–2005. Cancer Epidemiol Biomarkers 19:2097–2105

    Article  Google Scholar 

  2. Andersen BL (1985) Sexual functioning morbidity among cancer survivors — current status and future-research directions. Cancer 55:1835–1842

    Article  PubMed  CAS  Google Scholar 

  3. Baade PD, Fritschi L, Eakin EG (2006) Non-cancer mortality among people diagnosed with cancer (Australia). Cancer Causes Control 17:287–297

    Article  PubMed  Google Scholar 

  4. Bertolote JM, Fleischmann A, De Leo D, Bolhari J, Botega N, De Silva D, Tran Thi Thanh H, Phillips M, Schlebusch L, Varnik A, Vijayakumar L, Wasserman D (2005) Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey. Psychol Med 35:1457–1465

    Article  PubMed  Google Scholar 

  5. Boyle P, Levin B (2008) World Cancer Report 2008. IARC Nonserial Publication

  6. Bradley PK (2006) Racial and ethnic disparities in cancer care and survivorship. A research and education effort focuses on African American breast cancer survivors. Am J Nurs 106:22–23

    Article  PubMed  Google Scholar 

  7. Brown BW, Brauner C, Minnotte MC (1993) Noncancer deaths in white adult cancer patients. J Natl Cancer Inst 85:979–987

    Article  PubMed  CAS  Google Scholar 

  8. center NC (2012) Prevalence of cancer in Korea, 2009

  9. Chiu HF, Dai J, Xiang YT, Chan SS, Leung T, Yu X, Hou ZJ, Ungvari GS, Caine ED (2012) Suicidal thoughts and behaviors in older adults in rural China: a preliminary study. Int J Geriatr Psychiatry 27:1124–1130

    Article  PubMed  CAS  Google Scholar 

  10. Cho J, Guallar E, Hsu YJ, Shin DW, Lee WC (2010) A comparison of cancer screening practices in cancer survivors and in the general population: the Korean national health and nutrition examination survey (KNHANES) 2001–2007. Cancer Causes Control 21:2203–2212

    Article  PubMed  Google Scholar 

  11. Coups EJ, Ostroff JS (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711

    Article  PubMed  Google Scholar 

  12. Crosby AE, Han B, Ortega LA, Parks SE, Gfroerer J (2011) Suicidal thoughts and behaviors among adults aged >/=18 years—United States, 2008–2009 MMWR. Surveill Summ 60:1–22

    Google Scholar 

  13. Curtis R, Freedman D, Ron E, Ries L, Hacker D, Edwards B, Tucker M, Fraumeni Jr J (2006) New malignancies among cancer survivors: SEER cancer registries, 1973–2000 Bethesda, MD: National Cancer Institute

  14. Dalton SO, Laursen TM, Ross L, Mortensen PB, Johansen C (2009) Risk for hospitalization with depression after a cancer diagnosis: a nationwide, population-based study of cancer patients in Denmark from 1973 to 2003. J Clin Oncol 27:1440–1445

    Article  PubMed  Google Scholar 

  15. Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM (2005) Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol 23:5814–5830

    Article  PubMed  Google Scholar 

  16. Douchez J, Droz JP, Desclaux B, Allain Y, Fargeot P, Caty A, Charrot P (1993) Quality of life in long-term survivors of nonseminomatous germ cell testicular tumors. J Urol 149:498–501

    PubMed  CAS  Google Scholar 

  17. Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, McTiernan A, Rock CL, Thompson C, Gansler T, Andrews KS (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 56:323–353

    Article  PubMed  Google Scholar 

  18. Earle CC, Neville BA (2004) Under use of necessary care among cancer survivors. Cancer 101:1712–1719

    Article  PubMed  Google Scholar 

  19. Florin TA, Fryer GE, Miyoshi T, Weitzman M, Mertens AC, Hudson MM, Sklar CA, Emmons K, Hinkle A, Whitton J, Stovall M, Robison LL, Oeffinger KC (2007) Physical inactivity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev 16:1356–1363

    Article  PubMed  Google Scholar 

  20. Gaynes BN, West SL, Ford CA, Frame P, Klein J, Lohr KN (2004) Screening for suicide risk in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 140:822–835

    Article  PubMed  Google Scholar 

  21. Gigantesco A, Morosini P (2008) Development, reliability and factor analysis of a self-administered questionnaire which originates from the World Health Organization's Composite International Diagnostic Interview — Short Form (CIDI-SF) for assessing mental disorders Clinical practice and epidemiology in mental health : CP & EMH 4:8

  22. Gotay CC, Isaacs P, Pagano I (2004) Quality of life in patients who survive a dire prognosis compared to control cancer survivors. Psycho-oncology 13:882–892

    Article  PubMed  Google Scholar 

  23. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093

    Article  PubMed  Google Scholar 

  24. Hooning MJ, Botma A, Aleman BM, Baaijens MH, Bartelink H, Klijn JG, Taylor CW, van Leeuwen FE (2007) Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst 99:365–375

    Article  PubMed  Google Scholar 

  25. Ibrahim EM, Al-Homaidh A (2011) Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol 28:753–765

    Article  PubMed  Google Scholar 

  26. Johnston AK, Pirkis JE, Burgess PM (2009) Suicidal thoughts and behaviours among Australian adults: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust Nz J Psychiat 43:635–643

    Article  Google Scholar 

  27. Park JH, Kim KW (2011) A review of the epidemiology of depression in Korea. J Korean Med Assoc 54:362–369

    Article  Google Scholar 

  28. Jung KW, Won YJ, Park S, Kong HJ, Sung J, Shin HR, Park EC, Lee JS (2009) Cancer statistics in Korea: incidence, mortality and survival in 2005. J Korean Med Sci 24:995–1003

    Article  PubMed  Google Scholar 

  29. Kalton G (2009) Methods for oversampling rare subpopulations in social surveys. Surv Methodol 35:125–141

    Google Scholar 

  30. Kenfield SA, Stampfer MJ, Chan JM, Giovannucci E (2011) Smoking and prostate cancer survival and recurrence. JAMA 305:2548–2555

    Article  PubMed  CAS  Google Scholar 

  31. Kessler RC, Wittchen H-U, Abelson JM, McGonagle KA, Schwarz N, Kendler KS, Knauper B, Zhao S (1998) The World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF). Int J Methods Psychiatr Res 7:171–185

    Article  Google Scholar 

  32. Korea Centers for Disease Control and Prevention (2005) Korea National Health and Nutrition Examination Survey Raw Material Guideline. http://knhanes.cdc.go.kr/

  33. Kornblith AB, Herndon JE 2nd, Weiss RB, Zhang C, Zuckerman EL, Rosenberg S, Mertz M, Payne D, Jane Massie M, Holland JF, Wingate P, Norton L, Holland JC (2003) Long-term adjustment of survivors of early-stage breast carcinoma, 20 years after adjuvant chemotherapy. Cancer 98:679–689

    Article  PubMed  Google Scholar 

  34. Kwan ML, Kushi LH, Weltzien E, Tam EK, Castillo A, Sweeney C, Caan BJ (2010) Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol 28:4410–4416

    Article  PubMed  Google Scholar 

  35. Li CI, Daling JR, Porter PL, Tang MTC, Malone KE (2009) Relationship between potentially modifiable lifestyle factors and risk of second primary contralateral breast cancer among women diagnosed with estrogen receptor-positive invasive breast cancer. J Clin Oncol 27:5312–5318

    Article  PubMed  Google Scholar 

  36. Liavaag AH, Tonstad S, Pripp AH, Trope C, Dorum A (2009) Prevalence and determinants of metabolic syndrome and elevated Framingham risk score in epithelial ovarian cancer survivors: a controlled observational study. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 19:634–640

    Article  Google Scholar 

  37. Maliski SL, Sarna L, Evangelista L, Padilla G (2003) The aftermath of lung cancer: balancing the good and bad. Cancer Nurs 26:237–244

    Article  PubMed  Google Scholar 

  38. Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Thomas J, Nelson H, Whittom R, Hantel A, Schilsky RL, Fuchs CS (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541

    Article  PubMed  Google Scholar 

  39. Morris BA, Shakespeare-Finch J, Scott JL (2012) Posttraumatic growth after cancer: the importance of health-related benefits and newfound compassion for others Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20:749–756

    Google Scholar 

  40. National Cancer Center (2008) Cancer facts and figures. National Cancer Center, Goyang

    Google Scholar 

  41. Ness KK, Oakes JM, Punyko JA, Baker KS, Gurney JG (2005) Prevalence of the metabolic syndrome in relation to self, reported cancer history. Ann Epidemiol 15:202–206

    Article  PubMed  Google Scholar 

  42. Ness KK, Wall MM, Oakes JM, Robison LL, Gurney JG (2006) Physical performance limitations and participation restrictions among cancer survivors: a population-based study. Ann Epidemiol 16:197–205

    Article  PubMed  Google Scholar 

  43. Ogle KS, Swanson GM, Woods N, Azzouz F (2000) Cancer and comorbidity — redefining chronic diseases. Cancer 88:653–663

    Article  PubMed  CAS  Google Scholar 

  44. Park BW, Hwang SY (2012) Unmet needs of breast cancer patients relative to survival duration. Yonsei Med J 53:118–125

    Article  PubMed  Google Scholar 

  45. Park JH, Park EC, Kim SG, Lee SY (2008) Job loss and re-employment of cancer patients in Korean employees: a nationwide retrospective cohort study. J Clin Oncol 26:1302–1309

    Article  PubMed  Google Scholar 

  46. Park SM, Lim MK, Jung KW, Shin SA, Yoo KY, Yun YH, Huh BY (2007) Prediagnosis smoking, obesity, insulin resistance, and second primary cancer risk in male cancer survivors: National Health Insurance Corporation Study. J Clin Oncol 25:4835–4843

    Article  PubMed  Google Scholar 

  47. Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ (2003) Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc 103:323–328

    PubMed  Google Scholar 

  48. Polsky D, Doshi JA, Marcus S, Oslin D, Rothbard A, Thomas N, Thompson CL (2005) Long-term risk for depressive symptoms after a medical diagnosis. Arch Intern Med 165:1260–1266

    Article  PubMed  Google Scholar 

  49. Recklitis CJ, Diller LR, Li X, Najita J, Robison LL, Zeltzer L (2010) Suicide ideation in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 28:655–661

    Article  PubMed  Google Scholar 

  50. Redig AJ, Munshi HG (2010) Care of the cancer survivor: metabolic syndrome after hormone-modifying therapy. Am J Med 123(87):e81–e86

    Google Scholar 

  51. Satin JR, Linden W, Phillips MJ (2009) Depression as a predictor of disease progression and mortality in cancer patients. Cancer 115:5349–5361

    Article  PubMed  Google Scholar 

  52. Schoenborn CA (1986) Health habits of U.S. adults, 1985: the "Alameda 7" revisited. Public Health Rep 101:571–580

    Google Scholar 

  53. Shin DW, Ahn E, Kim H, Park S, Kim YA, Yun YH (2010) Non-cancer mortality among long-term survivors of adult cancer in Korea: national cancer registry study. Cancer Cause Control 21:919–929

    Article  Google Scholar 

  54. Tseng TS, Lin HY, Martin MY, Chen T, Partridge EE (2010) Disparities in smoking and cessation status among cancer survivors and non-cancer individuals: a population-based study from National Health and Nutrition Examination Survey. J Cancer Surviv Res Pract 4:313–321

    Article  Google Scholar 

  55. Wedding U, Koch A, Rohrig B, Pientka L, Sauer H, Hoffken K, Maurer I (2008) Depression and functional impairment independently contribute to decreased quality of life in cancer patients prior to chemotherapy. Acta Oncol 47:56–62

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the members of the Korea Institute for Health and Social Affairs who conducted the national survey and everyone who contributed to this project.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Family Medicine & Department of Biomedical Sciences, Seoul National University College of Medicine, 28 Yunkeon-dong, Jongro-gu, Seoul, 110-744, South Korea

    Sang Min Park

  2. Department of Family Medicine, Seoul National University Hospital, 28 Yunkeon-dong, Jongro-gu, Seoul, 110-744, South Korea

    Kyae Hyung Kim, Dong Wook Shin, Ju Hyun Lee & Young-Jin Ko

  3. Department of Internal Medicine, Seoul National University Hospital, 28 Yunkeon-dong, Jongro-gu, Seoul, 110-744, South Korea

    Young Youn Cho

Authors
  1. Kyae Hyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Young Youn Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dong Wook Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ju Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Young-Jin Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sang Min Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sang Min Park.

Additional information

K.H. Kim and Y.Y. Cho contributed equally to this work as first authors.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, K.H., Cho, Y.Y., Shin, D.W. et al. Comparison of physical and mental health status between cancer survivors and the general population: a Korean population-based survey (KNHANES II-IV). Support Care Cancer 21, 3471–3481 (2013). https://doi.org/10.1007/s00520-013-1939-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-013-1939-8

Keywords

Search

Navigation