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Gender-specific quality of life after cancer in young adulthood: a comparison with the general population

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Abstract

Purpose

Over the last years, adolescents and young adults with cancer (AYA) have moved strongly into scientific focus. However, there have only been a few studies about the quality of life of the AYA group, and gender differences have very rarely been examined.

Methods

A cross-sectional study was conducted with young adult cancer patients who were aged 18–39 years at the time of survey and had completed their acute treatment. We used the quality of life questionnaire European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). The EORTC QLQ-C30 contains five function scales (physical, role, emotional, cognitive and social), nine symptom scales and a global quality of life scale. The patient sample was compared to a gender- and age-matched representative sample (REP).

Results

Compared to the general population (N = 585), significantly poorer quality of life (p = .001) was observed for the 117 young cancer patients (40 male, 77 female) on all scales and items of the EORTC QLQ-C30. Analyses of variance with the factors group (AYA vs. REP) and gender showed interaction effects for the physical (p < .012), emotional (p < .029) and cognitive function scales (p < .008) and fatigue (p < .026) as well as for the items insomnia (p < .011), constipation (p < .037) and financial difficulties (p < .026). The pattern of the interaction was that female cancer patients reported the lowest quality of life outcomes. The same effects were found for the three calculated sum scales function, symptom and total.

Conclusions

Results clearly indicate that young adult cancer patients have a reduced quality of life in comparison with the general population even long after the treatment of their disease is complete. Women had a lower quality of life than men. Age-specific interventions should be offered that lead to improvements in quality of life for this age group. And future studies should clarify what factors lead to women’s quality of life being worse than men’s.

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References

  1. Midtgaard, J., & Quist, M. (2008). Proof of Life: A theoretical and empirical outline of a community and exercise based rehabilitation initiative developed by and for young adult cancer survivors. Recent Advances and Research Updates, 9(1), 63–71.

    Google Scholar 

  2. De, P., Ellison, L. F., Barr, R. D., Semenciw, R., Marrett, L. D., Weir, H. K., et al. (2011). Canadian adolescents and young adults with cancer: Opportunity to improve coordination and level of care. CMAJ: Canadian Medical Association Journal, 183(3), 187–194.

    Article  Google Scholar 

  3. Furlong, W., Rae, C., Greenberg, M. L., & Barr, R. D. (2012). Surveillance and survival among adolescents and young adults with cancer in Ontario, Canada. International Journal, 131, 2660–2667.

    CAS  Google Scholar 

  4. Adolescent and Young Adult Oncology Progress Review Group. (2006). Closing the gap: Research and care imperatives for adolescents and young adults with cancer. Bethesda, MD: Department of Health and Human Services, National Institutes of Health, National Cancer Institute, and the Live Strong Young Adult Alliance. NIH Publication No. 06-6067. http://planning.cancer.gov/library/AYAO_PRG_Report_2006_FINAL.pdf.

  5. Krebs in Deutschland 2005/2006 (2010). Häufigkeiten und Trends. 7. Ausgabe. Robert Koch-Institut, Hrsg. Und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V., Hrsg. Berlin.

  6. Borchmann, P., Heußner, P., Hilgendorf, I., Katalinic, A., Lawrenz, B., Neubauer, A., et al. (2012). Heranwachsende und junge Erwachsene (AYA, Adolescents and Young Adults). Onkopedia Leitlinien 2011. Verfügbar unter: http://www.dgho-onkopedia.de/onkopedia/leitlinien/heranwachsende-und-junge-erwachsene-aya.

  7. Engel, J., Freund, M., & Hölzel, D. (2011). Brauchen wir ein AYA-Netzwerk? Onkologie, 34(suppl. 5), 2–5.

    Article  PubMed  Google Scholar 

  8. Hilgendorf, I., Freund, M., Kroop, P., Hartmann, S., Krogmann, D., Daunke, A., et al. (2011). Onkologische Erkrankungen bei Jugendlichen und jungen Erwachsenen – Zahlen aus dem Klinischen Krebsregister Rostock als Arbeitsgrundlage für eine interdisziplinäre Herausforderung. Tumor Diagn und Therapie, 32(2), 85–92.

    Article  Google Scholar 

  9. Ramphal, R., Meyer, R., Schacter, B., Rogers, P., & Pinkerton, R. (2011). Active therapy and models of care for adolescents and young adults with cancer. Cancer, 117(suppl. 10), 2316–2322.

    Article  PubMed  Google Scholar 

  10. Zebrack, B. (2011). Psychological, social, and behavioral issues for young adults with cancer. Cancer, 117(suppl. 10), 2289–2294.

    Article  PubMed  Google Scholar 

  11. Thomas, D. M., Seymour, J. F., O’Brien, T., Sawyer, S. M., & Ashley, D. M. (2006). Adolescent and young adult cancer: A revolution in evolution? Internal Medicine Journal, 36(5), 302–307.

    Article  PubMed  CAS  Google Scholar 

  12. Pentheroudakis, G., & Pavlidis, N. (2005). Juvenile cancer: Improving care for adolescents and young adults within the frame of medical oncology. Annals of Oncology, 16(2), 181–188.

    Article  PubMed  CAS  Google Scholar 

  13. Haase, J. E., & Phillips, C. R. (2004). The adolescent/young adult experience. Journal of Pediatric Oncology Nursing, 21(3), 145–149.

    Article  PubMed  Google Scholar 

  14. Loren, A. W., Mangu, P. B., Nohr Beck, L., Brennan, L., Magdalinski, A. J., Partridge, A. H. et al. (2013). Fertility preservation for patients with cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. Journal of Clinical Oncology, 1–12. doi:10.1200/JCO.2013.49.2678.

  15. Lawrenz, B., Fehm, T., Neunhoeffer, E., Krämer, B., Soekler, M., Kanz, L., et al. (2011). Fertility preservation in young female lymphoma patients: Review of available options and initial experiences with their implementation in clinical routine. Onkologie, 34, 88–93.

    Article  PubMed  Google Scholar 

  16. Ferrari, A., Thomas, D., Franklin, A. R. K., Hayes-Lattin, B. M., Mascarin, M., van der Graaf, W., et al. (2010). Starting an adolescent and young adult program: Some success stories and some obstacles to overcome. Journal of Clinical Oncology, 28(32), 4850–4857.

    Article  PubMed  Google Scholar 

  17. Gondos, A., Hiripi, E., Holleczek, B., Luttmann, S., Eberle, A., & Brenner, H. (2013). Survival among Adolescents and young adults with cancer in Germany and the United States: An international comparison. International Journal of Cancer 1–9. doi:10.1002/ijc.28231.

  18. Enskär, K., & von Essen, L. (2007). Prevalence of aspects of distress, coping, support and care among adolescents and young adults undergoing and being off cancer treatment. European Journal of Oncology Nursing, 11, 400–408.

    Article  PubMed  Google Scholar 

  19. Erickson, J. M., Beck, S. L., Christian, B. R., Dudley, W., Hollen, P. J., Albritton, K. A., et al. (2011). Fatigue, sleep-wake disturbances, and quality of life in adolescents receiving chemotherapy. Journal of Pediatric Hematology/Oncology, 33(1), 17–25.

    Article  Google Scholar 

  20. Odo, R., & Potter, C. (2009). Understanding the needs of young adult cancer survivors: A clinical perspective. Oncology Nurse Edition, 23(11), 1–7.

    Google Scholar 

  21. Bleyer, A. (2002). Cancer in older adolescents and young adults: Epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Medical and Pediatric Oncology, 38(1), 1–10.

    Article  PubMed  Google Scholar 

  22. von Essen, L., Enskär, K., Kreuger, A., Larsson, B., & Sjöden, P. O. (2000). Self-esteem, depression and anx-iety among Swedish children and adolescents on and off cancer treatment. Acta Paediatrica, 89, 229–236.

    Article  Google Scholar 

  23. Pendley, J. S., Dahlquist, L. M., & Dreyer, Z. (1997). Body image and psychosocial adjustment in adolescent cancer survivors. Journal of Pediatric Psychology, 22(1), 29–43.

    Article  PubMed  CAS  Google Scholar 

  24. Larsson, G., Mattsson, E., & von Essen, L. (2010). Aspects of quality of life, anxiety, and depression among persons diagnosed with cancer during adolescence: a long-term follow-up study. European Journal of Cancer, 46, 1062–1068.

    Article  PubMed  Google Scholar 

  25. Dyson, G. J., Thompson, K., Palmer, S., Thomas, D. M., & Schofield, P. (2012). The relationship between unmet needs and distress amongst young people with cancer. Supportive Care in Cancer, 2012(20), 75–85.

    Article  Google Scholar 

  26. Krüger, A., Leibbrand, B., Barth, J., Berger, D., Lehmann, C., Koch, U., et al. (2009). Verlauf der psychosozialen Belastung und gesundheitsbezogenen Lebensqualität bei Patienten verschiedener Altersgruppen in der onkologischen Rehabilitation. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 55(2), 141–161.

    PubMed  Google Scholar 

  27. Seitz, D. C. M., Besier, T., Debatin, K. M., Grabow, D., Dieluweit, U., Hinz, A., et al. (2010). Posttraumatic stress, depression and anxiety among adult long-term survivors of cancer in adolescence. European Journal of Cancer, 46(9), 1596–1606.

    Article  PubMed  Google Scholar 

  28. Ladehoff, N., Koch, U., & Mehnert, A. (2011). Körperliche und psychosoziale Belastungen bei Jugendlichen und jungen Erwachsenen mit einer Krebserkrankung. Zeitschrift für Gesundheitspsychologie, 19(1), 43–64.

    Article  Google Scholar 

  29. Greenfield, D. M., Walters, S. J., Coleman, R. E., Hancock, B. W., Snowden, J. A., Shalet, S. M., et al. (2010). Quality of life, self-esteem, fatigue, and sexual function in young men after cancer: A controlled cross-sectional study. Cancer, 116(6), 1592–1601.

    Article  PubMed  Google Scholar 

  30. Hall, A. E., Boyes, A. W., Bowman, J., Walsh, R. A., James, E. L., & Girgis, A. (2012). Young adult cancer survivors’ psychosocial well-being: A cross-sectional study assessing quality of life, unmet needs, and health behaviors. Supportive Care in Cancer, 20, 1333–1341.

    Article  PubMed  Google Scholar 

  31. McDougall, J., & Tsonis, M. (2009). Quality of life in survivors of childhood cancer: A systematic review of the literature (2001–2008). Supportive Care in Cancer, 17, 1231–1246.

    Article  PubMed  Google Scholar 

  32. Hjermstadt, M. J., Fayers, P. M., Bjordal, K., & Kaasa, S. (1998). Using reference data on quality of life—The importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3). European Journal of Cancer, 34, 1381–1389.

    Article  Google Scholar 

  33. Schwarz, R., & Hinz, A. (2001). Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. European Journal of Cancer, 37, 1345–1351.

    Article  PubMed  CAS  Google Scholar 

  34. van de Poll-Franse, L. V., Mols, F., Gundy, C. M., Creutzberg, C. L., Nout, R. A., Leeuw, I. M. V., et al. (2011). Normative data for the EORTC QLQ-C30 and EORTC-sexuality items in the general Dutch population. European Journal of Cancer, 47, 667–675.

    Article  PubMed  Google Scholar 

  35. Jensen, R. E., Arora, N. K., Bellizzi, K. M., Rowland, J. H., Hamilton, A. S., Aziz, N. M., et al. (2013). Health-related quality of life among survivors of aggressive non-Hodgkin lymphoma. Cancer,. doi:10.1002/cncr.27781.

    Google Scholar 

  36. Smith, A. W., Bellizzi, K. M., Keegan, T. H. M., Zebrack, B., Chen, V. W., Neale, A. V., et al. (2013). Health-related quality of life of adolescent and young adult patients with cancer in the United States: The adolescent and young adult health outcomes and patient experience study. Journal of Clinical Oncology, 31(17), 2136–2148.

    Article  PubMed  Google Scholar 

  37. Hauser, W., Schmutzer, G., Brähler, E., & Glaesmer, H. (2011). Maltreatment in childhood and adolescence: Results from a survey of a representative sample of the German population. Deutsches Ärzteblatt International, 108, 287–294.

    PubMed Central  PubMed  Google Scholar 

  38. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of National Cancer Institute, 85, 365–376.

    Article  CAS  Google Scholar 

  39. Hinz, A., Einenkel, J., Stolzenburg, J. U., Papsdorf, K., & Singer, S. (2012). Is it useful to calculate sum scores of the quality of life questionnaire EORTC QLQ-C30? European Journal of Cancer Care, 21, 677–683.

    Article  PubMed  CAS  Google Scholar 

  40. Cocks, K., King, M. T., Velikova, G., Martyn St-James, M., Fayers, P. M., & Brown, J. M. (2011). Evidence-based guidelines for determination of sample size and interpretation of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Journal of Clinical Oncology, 29(1), 89–96.

    Article  PubMed  Google Scholar 

  41. Schumacher, J., Klaiberg, A., & Brähler, E. (2003). Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Bern, Toronto: Hogrefe Göttingen.

    Google Scholar 

  42. Howard-Anderson, J., Ganz, P. A., Bower, J. E., & Stanton, A. L. (2012). Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: A systematic review. Journal of National Cancer Institute, 104, 386–405.

    Article  Google Scholar 

  43. Barrera, M., Teall, T., Barr, R., Silva, M., & Greenberg, M. (2012). Health related quality of life in adolescent and young adult survivors of lower extremity bone tumors. Pediatric Blood & Cancer, 2012(58), 265–273.

    Article  Google Scholar 

  44. Jörngården, A., Mattsson, E., & von Essen, L. (2007). Health-related quality of life, anxiety and depression among adolescents and young adults with cancer: A prospective longitudinal study. European Journal of Cancer, 43, 1952–1958.

    Article  PubMed  Google Scholar 

  45. Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139–144.

    PubMed  CAS  Google Scholar 

  46. Dunn, J., & Steginga, S. K. (2000). Young women’s experience of breast cancer: Defining young and identifying concerns. Psycho-Oncology, 9, 137–146.

    Article  PubMed  CAS  Google Scholar 

  47. Armuand, G. M., Rodriguez-Wallberg, K. A., Wettergren, L., Ahkgren, J., Enblad, G., Höglund, M., et al. (2012). Sex differences in fertility-related information received by young adult cancer survivors. Journal of Clinical Oncology, 30, 2147–2153.

    Article  PubMed  Google Scholar 

  48. Peddie, V. L., Porter, M. A., Barbour, R., Culligan, D., MacDonald, G., Kind, D., et al. (2012). Factors affecting decision making about fertility preservation after cancer diagnosis: A qualitative study. Journal of Obstretrics and Gynaecology. doi:10.1111/j.1471-0528.2012.03368.x.

  49. Jenskins, V., Shilling, V., Fallowfield, L., Howell, A., & Hutton, S. (2004). Does hormone therapy for the treatment of breast cancer have a detrimental effect on memory and cognition? A pilot study. Psycho-Oncology, 13, 61–66.

    Article  Google Scholar 

  50. Prue, G., Rankin, J., Allen, J., et al. (2006). Cancer-related fatigue: A critical appraisal. European Journal of Cancer, 42, 846–863.

    Article  PubMed  CAS  Google Scholar 

  51. Servaes, P., Verhagen, C., & Bleijenberg, G. (2002). Fatigue in cancer Patients during and after treatment: Prevalence, correlates and interventions. European Journal of Cancer, 38, 27–43.

    Article  PubMed  CAS  Google Scholar 

  52. Zebrack, B. (2008). Information and service needs for young adult cancer patients. Supportive Care in Cancer, 16, 1353–1360.

    Article  PubMed  Google Scholar 

  53. D’Agostino, N. M., Penney, A., & Zebrack, B. (2011). Providing developmentally appropriate psychosocial care to adolescent and young adult cancer survivors. Cancer, 117(suppl. 10), 2329–2334.

    Article  PubMed  Google Scholar 

  54. Dieluweit, U., Seitz, D. C. M., Besier, T., Debatin, K. M., Grabow, D., Kaatsch, P., et al. (2011). Utilization of psychosocial care and oncological follow-up assessments among German long-term survivors of cancer with onset during adolescence. Klinische Pädiatrie, 223(3), 152–158.

    Article  PubMed  CAS  Google Scholar 

  55. Phillips-Salami, C. R., & Andrykowski, M. A. (2013). Physical and mental health status of female adolescent/young adult survivors of breast and gynaecological cancer: A national, population-based, case–control study. Supportive Care in Cancer, 21, 1597–1604.

    Article  Google Scholar 

  56. RKI. (2010). Gesellschaft der epidemiologischen Krebsregister in Deutschland/Robert-Koch Institut: Krebs in Deutschland 2005–2006, Häufigkeiten und Trends: Niere, 6. Auflage, 80–83. http://www.ekr.med.uni-erlangen.de/GEKID/.

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Acknowledgments

The study was sponsored by the junior research grant by the Medical Faculty, University of Leipzig.

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Correspondence to Kristina Geue.

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Geue, K., Sender, A., Schmidt, R. et al. Gender-specific quality of life after cancer in young adulthood: a comparison with the general population. Qual Life Res 23, 1377–1386 (2014). https://doi.org/10.1007/s11136-013-0559-6

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