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Trajectory of overall health from self-report and factors contributing to health declines among cancer survivors

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Abstract

Purpose

This study aims to quantify trajectories of overall health pre- and post-diagnosis of cancer, trajectories of overall health among cancer-free individuals, and factors affecting overall health status.

Methods

Overall health status, derived from self-rated health report, of Atherosclerosis Risk in Communities cohort participants diagnosed with incident cancer [lung (n = 400), breast (n = 522), prostate (n = 615), colorectal (n = 303)], and cancer-free participants (n = 11,634) over 19 years was examined. Overall health was evaluated in two ways: (1) overall health was assessed until death or follow-up year 19 (survivorship model) and (2) same as survivorship model except that a self-rated health value of zero was used for assessments after death to follow-up year 19 (cohort model). Mean overall health at discrete times was used to generate overall health trajectories. Differences in repeated measures of overall health were assessed using linear growth models.

Results

Overall health trajectories declined dramatically within one-year of cancer diagnosis. Lung, breast, and colorectal cancer were associated with a significant decreased overall health score (β) compared to the cancer-free group (survivorship model: lung—7.00, breast—3.97, colorectal—2.12; cohort model: lung—7.63, breast—5.07, colorectal—2.30). Other predictors of decreased overall health score included low education, diabetes, cardiovascular disease, and age.

Conclusions

All incident cancer groups had declines in overall health during the first year post-diagnosis, which could be due to cancer diagnosis or intensive treatments. Targeting factors related to overall health declines could improve health outcomes for cancer patients.

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Acknowledgments

The authors thank the staff and participants of the ARIC study for their important contributions and Dr. Christy Avery for her statistical expertise. Cancer incidence data have been provided by the Maryland Cancer Registry, Center for Cancer Surveillance and Control, Department of Mental Health and Hygiene, 201 W. Preston Street, Room 400, Baltimore, MD 21201. We acknowledge the State of Maryland, the Maryland Cigarette Restitution Fund, and the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC) for the funds that helped support the availability of the cancer registry data. The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C). Studies on cancer in ARIC are also supported by the National Cancer Institute (U01 CA164975-01). The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Jessica L. Petrick, Anna M. Kucharska-Newton & Debra E. Irwin

  2. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA

    Randi E. Foraker

  3. Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Bryce B. Reeve & Sally C. Stearns

  4. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Elizabeth A. Platz

  5. Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA

    Xuesong Han

  6. The University of Mississippi Medical Center, Jackson, MS, USA

    B. Gwen Windham

Authors
  1. Jessica L. Petrick
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  2. Randi E. Foraker
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  3. Anna M. Kucharska-Newton
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  4. Bryce B. Reeve
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  6. Sally C. Stearns
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  7. Xuesong Han
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  8. B. Gwen Windham
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  9. Debra E. Irwin
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Corresponding author

Correspondence to Jessica L. Petrick.

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Petrick, J.L., Foraker, R.E., Kucharska-Newton, A.M. et al. Trajectory of overall health from self-report and factors contributing to health declines among cancer survivors. Cancer Causes Control 25, 1179–1186 (2014). https://doi.org/10.1007/s10552-014-0421-3

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  • DOI: https://doi.org/10.1007/s10552-014-0421-3

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