Contextual Factors Associated with Health-Related Quality of Life in Older Adult Cancer Survivors

Abstract

1. Abstract 1.1. Aims: The purpose of this study was to examine contextual factors associated with physical and mental health-related quality of life (HRQOL) in older adult cancer survivors. 1.2. Methods: This study is a secondary data analysis of the 2014 Behavioral Risk Factor Surveillance System. Only adults age 65 and older who had a cancer history in the Cancer Survivorship module were included (n=3,846). 1.3. Results: Racialethnic minorities were 52% less likely to report good mental HRQOL compared to non-Hispanic whites. Having completed treatment also improved odds of having good mental HRQOL. Being employed and having exercised in the past month increased likelihood of having good physical HRQOL. Having physical comorbidities and a history of depression were related to poor mental HRQOL. 1.4. Conclusion: Older adult cancer survivors who are unmarried, experienced cost as a barrier to care, have physical comorbidities, or a history of depression should be included in interventions to improve HRQOL. Special attention should be paid to older adult cancer survivors who have had a stroke, as they could be at greater risk of poor physical and mental HRQOL. To reduce disparities in HRQOL of cancer survivors, greater effort needs to be made to improve the HRQOL of racial/ethnic minorities and those facing difficulties completing treatment. Greater research is needed to understand the effect of race, aging, and cancer on HRQOL 2. Introduction Adults diagnosed with cancer are living longer now than ever before. Today, 69% of cancer patients in the United States (U.S.) can expect to survive 5 years or more beyond diagnosis, up 20% from the previous three decades [1]. Of these cancer survivors, 62% are older adults (age 65 years or older); by 2040, this proportion is expected to climb to 73%, resulting in over 19 million older adult cancer survivors [2]. Recognizing these trends, professional organizations and governmental agencies, such as the American Society of Clinical Oncology and the National Institutes of Health have developed best practices for providing clinical care to older adult cancer survivors with the aim of promoting health-related quality of life (HRQOL). HRQOL is a subjective assessment of the impact of a disease on an individual’s quality of life, particularly the extent to which the disease interferes with one’s physical and mental functioning [3]. It is also a meaningful metric for assessing a cancer patient’s well-being in comparison to the non-cancer population [4, 5]. Furthermore, HRQOL has strong prognostic value, as HRQOL declines are linked to poorer survival following diagnosis. As greater survival is achieved from cancer, HRQOL is increasingly being recognized as an important endpoint in clinical cancer care. It is widely acknowledged that older adult cancer survivors experience worse HRQOL following a cancer diagnosis. Cancer and its sequelae can cause chronic pain, fatigue, and other decrements in physical functioning [6-9]. For instance, it is not uncommon for pa-