Substantial number of cancer survivors experience poor mental or physical health years after cancer

Survivors of many common cancers enjoy a mental and physical health-related quality of life equal to that of adults who have not had cancer, but survivors of other cancers are in poorer health, according to results published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

"We did not have a good sense of how cancer survivors across the United States were faring after their cancer diagnosis and immediate treatment," said Kathryn E. Weaver, Ph.D., M.P.H., assistant professor at Wake Forest Baptist Medical Center in Winston-Salem, N.C. "We set out to address this issue by estimating the number and percent of cancer survivors in the United States with poor physical and mental health and compared them to adults who have never had a cancer diagnosis."

Weaver and colleagues from the National Cancer Institute (NCI) and the Centers for Disease Control and Prevention (CDC) analyzed data from the 2010 National Health Interview Survey, a large survey conducted by the CDC to track trends in illness and disability in the United States. They identified a cohort of 1,822 cancer survivors and compared them with 24,804 adults with no history of cancer.

Patient-reported, health-related quality of life was assessed using the 10-item Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10). This tool allows researchers to measure, from the patient perspective, health outcomes like physical functioning, depression, pain and fatigue.

After adjusting for gender, race/ethnicity, education and other medical conditions, it was found that the most recent form of cancer a patient was diagnosed with was significantly related to health-related quality of life. Survivors of breast cancer, prostate cancer and melanoma had a health-related quality of life equivalent to or better than adults with no cancer history.

In contrast, survivors of cervical, blood and colorectal cancers, as well as survivors of cancers with a five-year survival rate of less than 25 percent (such as cancers of the liver, lung and pancreas), had worse physical health-related quality of life. In addition, survivors of cervical cancer and cancers with a low five-year survival rate had worse mental health-related quality of life.

Twenty-five percent and 10 percent of cancer survivors in the analytic sample had lower than normal physical and mental health-related quality of life, respectively. Weaver and colleagues, therefore, estimated that 3.3 million cancer survivors in the United States have below-average physical health-related quality of life and almost 1.4 million have below-average mental health-related quality of life.

"It is very concerning that there are a substantial number of cancer survivors who experience poor mental or physical health years after cancer," said Weaver. "Our results will serve as a baseline so that in five to 10 years, we can assess whether current approaches to improving the health and well-being of cancer survivors are having a positive effect.

"I also hope our data will draw attention to the ongoing needs of cancer survivors - particularly those with cervical, blood and less common cancers - and to the importance of monitoring these individuals, even long after their cancer diagnosis."