The impact of comorbidity on Health-Related Quality of Life among cancer survivors

Analyses of data from the PROFILES registry

P.A.J. Vissers, M.S.Y. Thong, F. Pouwer, M.M.J. Zanders, J.W.W. Coebergh, L.V. van de Poll-Franse

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Purpose
The aim of this study was to assess the difference in explained variance of Health-Related Quality of Life (HRQoL) between comorbidity, sociodemographic characteristics and cancer characteristics. This association was assessed among thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma patients.
Methods
Data from three large population-based surveys on survivors of thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma were used. Cancer-specific HRQoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) of which physical function, emotional function, fatigue, and pain were included in the analyses. Comorbidity was assessed using the Self-reported Comorbidity Questionnaire. The association between comorbidity and HRQoL was assessed with multivariate linear regression models. Semi-partial R2 was reported to assess the amount of variance in HRQoL explained by comorbidity in comparison with sociodemographic and cancer characteristics.
Results
In total, 3,792 cancer survivors were included in this analysis. The variance in HRQoL subscales explained by comorbidity was higher compared with sociodemographic and cancer characteristics for physical function (11–17 vs. 2–4 and 1–2 %, respectively) and emotional function (7–17 vs. 1–3 and 1–3 %, respectively), regardless of cancer type. In addition, comorbidity explained 7–20 and 11–13 % of the variance in pain and fatigue, respectively, compared to 0–4 % for both sociodemographic and cancer characteristics. Osteoarthritis and back pain were strongly associated with physical function and pain, while depression was strongly associated with emotional function. Depression and back pain were strongly associated with fatigue.
Conclusions
This study showed that comorbidity explained more variance in physical and emotional function, pain, and fatigue in comparison with sociodemographic and cancer characteristics in cancer survivors, regardless of cancer type. Our findings emphasize the importance of adjusting for the presence of comorbid diseases when assessing HRQoL in cancer survivors.
Implication for cancer survivors
Cancer survivors suffering from comorbid diseases experience lower levels of health-related quality of life. Clinicians should become more aware of the impact of comorbidity on HRQoL and provide necessary psychological support to assist self-management of comorbid diseases.
Keywords: Health-related quality of life, Cancer, Comorbidity, Elderly/ Population-based
Original languageEnglish
Pages (from-to)602-613
JournalJournal of Cancer Survivorship
Volume7
Issue number4
DOIs
Publication statusPublished - 2013

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Survivors
Comorbidity
Neoplasms
Non-Hodgkin's Lymphoma
Linear Models
Depression
Organizations

Cite this

Vissers, P.A.J. ; Thong, M.S.Y. ; Pouwer, F. ; Zanders, M.M.J. ; Coebergh, J.W.W. ; van de Poll-Franse, L.V. / The impact of comorbidity on Health-Related Quality of Life among cancer survivors : Analyses of data from the PROFILES registry. In: Journal of Cancer Survivorship. 2013 ; Vol. 7, No. 4. pp. 602-613.
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title = "The impact of comorbidity on Health-Related Quality of Life among cancer survivors: Analyses of data from the PROFILES registry",
abstract = "PurposeThe aim of this study was to assess the difference in explained variance of Health-Related Quality of Life (HRQoL) between comorbidity, sociodemographic characteristics and cancer characteristics. This association was assessed among thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma patients.MethodsData from three large population-based surveys on survivors of thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma were used. Cancer-specific HRQoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) of which physical function, emotional function, fatigue, and pain were included in the analyses. Comorbidity was assessed using the Self-reported Comorbidity Questionnaire. The association between comorbidity and HRQoL was assessed with multivariate linear regression models. Semi-partial R2 was reported to assess the amount of variance in HRQoL explained by comorbidity in comparison with sociodemographic and cancer characteristics.ResultsIn total, 3,792 cancer survivors were included in this analysis. The variance in HRQoL subscales explained by comorbidity was higher compared with sociodemographic and cancer characteristics for physical function (11–17 vs. 2–4 and 1–2 {\%}, respectively) and emotional function (7–17 vs. 1–3 and 1–3 {\%}, respectively), regardless of cancer type. In addition, comorbidity explained 7–20 and 11–13 {\%} of the variance in pain and fatigue, respectively, compared to 0–4 {\%} for both sociodemographic and cancer characteristics. Osteoarthritis and back pain were strongly associated with physical function and pain, while depression was strongly associated with emotional function. Depression and back pain were strongly associated with fatigue.ConclusionsThis study showed that comorbidity explained more variance in physical and emotional function, pain, and fatigue in comparison with sociodemographic and cancer characteristics in cancer survivors, regardless of cancer type. Our findings emphasize the importance of adjusting for the presence of comorbid diseases when assessing HRQoL in cancer survivors.Implication for cancer survivorsCancer survivors suffering from comorbid diseases experience lower levels of health-related quality of life. Clinicians should become more aware of the impact of comorbidity on HRQoL and provide necessary psychological support to assist self-management of comorbid diseases.Keywords: Health-related quality of life, Cancer, Comorbidity, Elderly/ Population-based",
author = "P.A.J. Vissers and M.S.Y. Thong and F. Pouwer and M.M.J. Zanders and J.W.W. Coebergh and {van de Poll-Franse}, L.V.",
year = "2013",
doi = "10.1007/s11764-013-0299-1",
language = "English",
volume = "7",
pages = "602--613",
journal = "Journal of Cancer Survivorship",
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The impact of comorbidity on Health-Related Quality of Life among cancer survivors : Analyses of data from the PROFILES registry. / Vissers, P.A.J.; Thong, M.S.Y.; Pouwer, F.; Zanders, M.M.J.; Coebergh, J.W.W.; van de Poll-Franse, L.V.

In: Journal of Cancer Survivorship, Vol. 7, No. 4, 2013, p. 602-613.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The impact of comorbidity on Health-Related Quality of Life among cancer survivors

T2 - Analyses of data from the PROFILES registry

AU - Vissers, P.A.J.

AU - Thong, M.S.Y.

AU - Pouwer, F.

AU - Zanders, M.M.J.

AU - Coebergh, J.W.W.

AU - van de Poll-Franse, L.V.

PY - 2013

Y1 - 2013

N2 - PurposeThe aim of this study was to assess the difference in explained variance of Health-Related Quality of Life (HRQoL) between comorbidity, sociodemographic characteristics and cancer characteristics. This association was assessed among thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma patients.MethodsData from three large population-based surveys on survivors of thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma were used. Cancer-specific HRQoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) of which physical function, emotional function, fatigue, and pain were included in the analyses. Comorbidity was assessed using the Self-reported Comorbidity Questionnaire. The association between comorbidity and HRQoL was assessed with multivariate linear regression models. Semi-partial R2 was reported to assess the amount of variance in HRQoL explained by comorbidity in comparison with sociodemographic and cancer characteristics.ResultsIn total, 3,792 cancer survivors were included in this analysis. The variance in HRQoL subscales explained by comorbidity was higher compared with sociodemographic and cancer characteristics for physical function (11–17 vs. 2–4 and 1–2 %, respectively) and emotional function (7–17 vs. 1–3 and 1–3 %, respectively), regardless of cancer type. In addition, comorbidity explained 7–20 and 11–13 % of the variance in pain and fatigue, respectively, compared to 0–4 % for both sociodemographic and cancer characteristics. Osteoarthritis and back pain were strongly associated with physical function and pain, while depression was strongly associated with emotional function. Depression and back pain were strongly associated with fatigue.ConclusionsThis study showed that comorbidity explained more variance in physical and emotional function, pain, and fatigue in comparison with sociodemographic and cancer characteristics in cancer survivors, regardless of cancer type. Our findings emphasize the importance of adjusting for the presence of comorbid diseases when assessing HRQoL in cancer survivors.Implication for cancer survivorsCancer survivors suffering from comorbid diseases experience lower levels of health-related quality of life. Clinicians should become more aware of the impact of comorbidity on HRQoL and provide necessary psychological support to assist self-management of comorbid diseases.Keywords: Health-related quality of life, Cancer, Comorbidity, Elderly/ Population-based

AB - PurposeThe aim of this study was to assess the difference in explained variance of Health-Related Quality of Life (HRQoL) between comorbidity, sociodemographic characteristics and cancer characteristics. This association was assessed among thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma patients.MethodsData from three large population-based surveys on survivors of thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma were used. Cancer-specific HRQoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) of which physical function, emotional function, fatigue, and pain were included in the analyses. Comorbidity was assessed using the Self-reported Comorbidity Questionnaire. The association between comorbidity and HRQoL was assessed with multivariate linear regression models. Semi-partial R2 was reported to assess the amount of variance in HRQoL explained by comorbidity in comparison with sociodemographic and cancer characteristics.ResultsIn total, 3,792 cancer survivors were included in this analysis. The variance in HRQoL subscales explained by comorbidity was higher compared with sociodemographic and cancer characteristics for physical function (11–17 vs. 2–4 and 1–2 %, respectively) and emotional function (7–17 vs. 1–3 and 1–3 %, respectively), regardless of cancer type. In addition, comorbidity explained 7–20 and 11–13 % of the variance in pain and fatigue, respectively, compared to 0–4 % for both sociodemographic and cancer characteristics. Osteoarthritis and back pain were strongly associated with physical function and pain, while depression was strongly associated with emotional function. Depression and back pain were strongly associated with fatigue.ConclusionsThis study showed that comorbidity explained more variance in physical and emotional function, pain, and fatigue in comparison with sociodemographic and cancer characteristics in cancer survivors, regardless of cancer type. Our findings emphasize the importance of adjusting for the presence of comorbid diseases when assessing HRQoL in cancer survivors.Implication for cancer survivorsCancer survivors suffering from comorbid diseases experience lower levels of health-related quality of life. Clinicians should become more aware of the impact of comorbidity on HRQoL and provide necessary psychological support to assist self-management of comorbid diseases.Keywords: Health-related quality of life, Cancer, Comorbidity, Elderly/ Population-based

U2 - 10.1007/s11764-013-0299-1

DO - 10.1007/s11764-013-0299-1

M3 - Article

VL - 7

SP - 602

EP - 613

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

SN - 1932-2259

IS - 4

ER -