TY - JOUR
T1 - Disparities in quality of life, social distress and employment outcomes in Australian cancer survivors
AU - White, Victoria M.
AU - Lisy, Karolina
AU - Ward, Andrew
AU - Ristevski, Eli
AU - Clode, Melanie
AU - Webber, Kate
AU - Emery, Jon
AU - IJzerman, Maarten J.
AU - Afshar, Nina
AU - Millar, Jeremy
AU - Gibbs, Peter
AU - Evans, Sue
AU - Jefford, Michael
N1 - Funding Information:
The original study was funded by the Victorian Comprehensive Cancer Centre. Prof Jim Bishop and Dr Karen Lacey led the design and implementation of the survey. The investigators acknowledge the contribution of the Victorian Cancer Registry in identifying potentially eligible participants and undertaking data collection for this study. We wish to thank the cancer survivors who took part in this study for sharing their experiences with us. This paper was produced as part of the INVAVICUS study. The authors acknowledge the contribution of members of the INVAVICUS study team: Ms Nikki Davis, Mr Colin O’Brien, Dr Colin Wood and Ms Liz Simkiss.
Funding Information:
Ethics approval was granted by the Cancer Council Victoria Human Research Ethics Committee (Project No: HREC 1307).
Funding Information:
The original study was funded by the Victorian Comprehensive Cancer Centre. Prof Jim Bishop and Dr Karen Lacey led the design and implementation of the survey. The investigators acknowledge the contribution of the Victorian Cancer Registry in identifying potentially eligible participants and undertaking data collection for this study. We wish to thank the cancer survivors who took part in this study for sharing their experiences with us. This paper was produced as part of the INVAVICUS study. The authors acknowledge the contribution of members of the INVAVICUS study team: Ms Nikki Davis, Mr Colin O?Brien, Dr Colin Wood and Ms Liz Simkiss.
Funding Information:
Open Access funding enabled and organized by CAUL and its Member Institutions. This research was funded by the Victorian Cancer Agency, Health services research project in cancer survivorship—HSR19001.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - Purpose: To examine how socio-demographic, comorbidities and information needs influence quality of life (QoL) outcomes of survivors of breast, colorectal, or prostate cancer, non-Hodgkin lymphoma or melanoma. Methods: Cross-sectional postal survey with eligible participants identified through a population-based cancer registry. QoL outcomes were assessed by EQ-5D-5L, social difficulties index (SDI) and, for those employed at diagnosis, current employment. Regression analyses explored associations between outcome variables and cancer type, age, time since diagnosis, residential location, socio-economic disadvantage, comorbidities and unmet information needs. Mediation analyses examined whether comorbidities and information needs explained relationships between outcome variables and socio-economic disadvantage. Results: 2115 survivors participated. Mean EQ-5D-5L scores (mean = 0.84) were similar to population averages and SDI scores were low for the entire sample (mean = 3.80). In multivariate analyses, being aged over 80, greater socio-economic disadvantage, comorbidities and unmet information needs decreased EQ-5D-5L scores. Higher SDI scores were associated with socio-economic disadvantage, comorbidities and unmet information needs. Not being employed was associated with being aged over 50, more comorbidities and socio-economic disadvantage. Comorbidities but not information needs partially mediated the impact of socio-economic disadvantage on EQ-5D-5L and SDI accounting for 17% and 14% of the total effect of socio-economic disadvantage respectively. Neither comorbidities nor information needs mediated the association between socio-economic disadvantage and employment outcomes. Conclusions: To improve quality of life, survivorship care should be better tailored to address the needs of individuals given their overall health and impact of comorbidities, their age and type of cancer and not simply time since diagnosis.
AB - Purpose: To examine how socio-demographic, comorbidities and information needs influence quality of life (QoL) outcomes of survivors of breast, colorectal, or prostate cancer, non-Hodgkin lymphoma or melanoma. Methods: Cross-sectional postal survey with eligible participants identified through a population-based cancer registry. QoL outcomes were assessed by EQ-5D-5L, social difficulties index (SDI) and, for those employed at diagnosis, current employment. Regression analyses explored associations between outcome variables and cancer type, age, time since diagnosis, residential location, socio-economic disadvantage, comorbidities and unmet information needs. Mediation analyses examined whether comorbidities and information needs explained relationships between outcome variables and socio-economic disadvantage. Results: 2115 survivors participated. Mean EQ-5D-5L scores (mean = 0.84) were similar to population averages and SDI scores were low for the entire sample (mean = 3.80). In multivariate analyses, being aged over 80, greater socio-economic disadvantage, comorbidities and unmet information needs decreased EQ-5D-5L scores. Higher SDI scores were associated with socio-economic disadvantage, comorbidities and unmet information needs. Not being employed was associated with being aged over 50, more comorbidities and socio-economic disadvantage. Comorbidities but not information needs partially mediated the impact of socio-economic disadvantage on EQ-5D-5L and SDI accounting for 17% and 14% of the total effect of socio-economic disadvantage respectively. Neither comorbidities nor information needs mediated the association between socio-economic disadvantage and employment outcomes. Conclusions: To improve quality of life, survivorship care should be better tailored to address the needs of individuals given their overall health and impact of comorbidities, their age and type of cancer and not simply time since diagnosis.
KW - Cancer
KW - Cancer survivors
KW - Disparities
KW - Employment
KW - Patient-reported outcomes
KW - Quality of life
KW - Social difficulties
UR - http://www.scopus.com/inward/record.url?scp=85126107329&partnerID=8YFLogxK
U2 - 10.1007/s00520-022-06914-w
DO - 10.1007/s00520-022-06914-w
M3 - Article
C2 - 35279769
AN - SCOPUS:85126107329
SN - 0941-4355
VL - 30
SP - 5299
EP - 5309
JO - Supportive care in cancer
JF - Supportive care in cancer
IS - 6
ER -
