Service and Suffering: Comparative Analyses of Health-Related Quality of Life Among Veteran and Civilian Cancer Survivors.

IF 3.9 2区医学 Q2 ONCOLOGY

Psycho‐Oncology Pub Date : 2026-09-01 DOI:10.1002/pon.70596

Qaidar Alizai, Odysseas P Chatzipanagiotou, Areesh Mevawalla, Azza Sarfraz, Meher Angez, Rida Ejaz, Abdulaziz Elemosho, Sebastian Ekenze, R Connor Chick, Timothy M Pawlik

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引用次数: 0

Abstract

Background: Veterans report greater comorbidity and psychosocial burden but have enhanced healthcare access through the Veterans Health Administration (VHA). We sought to characterize health-related quality of life (HRQoL) differences between veteran and civilian cancer survivors.

Methods: We analyzed cancer survivors from the 2017-2022 Behavioral Risk Factor Surveillance System. Outcomes included fair/poor general health, poor physical health, poor mental health, and activity-limiting poor health. Sex-stratified, survey-weighted Poisson regression with robust variance estimated incidence rate ratios (IRRs) for day-count outcomes and prevalence ratios (PRs) for binary outcomes, controlling for sociodemographic and clinical covariates.

Results: Among 65,613 survivors (32,710 men; 32,903 women), 11,213 men (34.3%) and 753 women (2.3%) were veterans. Male veterans were older than civilian men (≥ 75 y: 54.4% vs. 25.9%), less likely to be employed (20.1% vs. 39.6%) or be college graduates (41.9% vs. 47.5%), and frequently reported history of cerebrovascular accident (9.8% vs. 5.7%) or coronary artery disease (25.4% vs. 15.9%) (all p < 0.001). Compared with female civilians, female veterans reported no differences in education, employment status, or history of chronic conditions (p > 0.05). Among female cancer survivors, veteran status was associated with higher prevalence of poor physical-health (aPR 1.35, 95% CI 1.02-1.77) and poor mental-health (aPR 1.45, 95% CI 1.06-1.98). Among males, veteran status was not associated with poor physical or mental health (all p > 0.05).

Conclusions: The findings highlight the importance of sex-responsive survivorship care integrating chronic-disease management, mental-health support, and social-risk screening across VHA and civilian systems.

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服务与痛苦：退伍军人与平民癌症幸存者健康相关生活质量的比较分析。

背景：退伍军人报告更多的合并症和心理社会负担，但通过退伍军人健康管理局（VHA）提高了医疗保健的可及性。我们试图描述退伍军人和平民癌症幸存者之间健康相关生活质量（HRQoL）的差异。方法：我们分析了2017-2022年行为风险因素监测系统中的癌症幸存者。结果包括一般/较差的总体健康状况、较差的身体健康状况、较差的心理健康状况和限制活动的较差健康状况。性别分层，调查加权泊松回归与稳健方差估计发病率比（IRRs）的日计数结果和患病率比（PRs）的二元结果，控制社会人口统计学和临床协变量。结果：65,613名幸存者中，男性32,710人，女性32,903人，其中男性11,213人（34.3%），女性753人（2.3%）。男性退伍军人年龄大于平民男性（≥75岁：54.4% vs. 25.9%），就业（20.1% vs. 39.6%）或大学毕业生（41.9% vs. 47.5%）的可能性较低，经常报告有脑血管事故（9.8% vs. 5.7%）或冠状动脉疾病（25.4% vs. 15.9%）（均p 0.05）。在女性癌症幸存者中，退伍军人身份与身体健康状况不佳（aPR 1.35, 95% CI 1.02-1.77）和精神健康状况不佳（aPR 1.45, 95% CI 1.06-1.98）的患病率较高相关。在男性中，退伍军人身份与身体或心理健康状况不佳无关（p < 0.05）。结论：研究结果强调了在VHA和民用系统中整合慢性病管理、心理健康支持和社会风险筛查的性别反应性生存护理的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.