Nataliia Moshina , Ragnhild S. Falk , Edoardo Botteri , Marthe Larsen , Lars A. Akslen , Giske Ursin , John A. Cairns , Solveig Hofvind
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We aimed to compare self-reported long-term HRQoL and quality adjusted life years (QALYs) between women with screen-detected breast cancer and women with symptomatic breast cancer, adjusting for histopathologic tumor characteristics and treatment.</div></div><div><h3>Methods</h3><div>This study was nested within a cohort of women diagnosed with breast cancer by organized mammographic screening or due to symptoms 2006–2017 who responded a questionnaire measuring HRQoL (VAS, 0–100) and EQ-5D-5L 2019–2020. Responses to EQ-5D-5L were transformed into health utility values using a tariff based on preferences elicited in a national survey. Multivariable linear regression models were used to compare VAS-scores adjusting for tumor characteristics and treatment. QALYs were estimated by summing up the health utility values between the third and the fifth year since breast cancer diagnosis adjusting for breast cancer survival.</div></div><div><h3>Results</h3><div>Mean HRQoL (VAS) was 66.2 (standard deviation, SD: 21.1) for women with screen-detected breast cancer (n = 1141) and 62.5 (SD: 21.2) for women with symptomatic breast cancer (n = 1561). Women with screen-detected breast cancer had 3.8 (95 % confidence interval, CI, 2.3, 5.4) and 3.7 (95 %CI 2.1, 5.2) higher HRQoL VAS-scores compared to women with symptomatic breast cancer in the models adjusted for tumor characteristics and treatment, respectively. Women with screen-detected breast cancer and women with symptomatic breast cancer accrued 2.30 and 2.06 QALYs, respectively.</div></div><div><h3>Conclusion</h3><div>Women with screen-detected breast cancer demonstrated higher estimates of long-term HRQoL and QALYs compared to women with symptomatic cancer.</div></div><div><h3>Policy Summary</h3><div>More favorable long-term quality of life outcomes were shown for women diagnosed with breast cancer by organized mammographic screening compared to women diagnosed due to symptoms.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100631"},"PeriodicalIF":2.0000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term quality of life and quality adjusted life years after breast cancer: Impact of detection mode, tumor characteristics and treatment\",\"authors\":\"Nataliia Moshina , Ragnhild S. Falk , Edoardo Botteri , Marthe Larsen , Lars A. Akslen , Giske Ursin , John A. Cairns , Solveig Hofvind\",\"doi\":\"10.1016/j.jcpo.2025.100631\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Health-related quality of life (HRQoL) of breast cancer survivors has been extensively evaluated. However, HRQoL differences for women diagnosed by organized mammographic screening and women diagnosed due to symptoms have been sparsely described. We aimed to compare self-reported long-term HRQoL and quality adjusted life years (QALYs) between women with screen-detected breast cancer and women with symptomatic breast cancer, adjusting for histopathologic tumor characteristics and treatment.</div></div><div><h3>Methods</h3><div>This study was nested within a cohort of women diagnosed with breast cancer by organized mammographic screening or due to symptoms 2006–2017 who responded a questionnaire measuring HRQoL (VAS, 0–100) and EQ-5D-5L 2019–2020. Responses to EQ-5D-5L were transformed into health utility values using a tariff based on preferences elicited in a national survey. Multivariable linear regression models were used to compare VAS-scores adjusting for tumor characteristics and treatment. QALYs were estimated by summing up the health utility values between the third and the fifth year since breast cancer diagnosis adjusting for breast cancer survival.</div></div><div><h3>Results</h3><div>Mean HRQoL (VAS) was 66.2 (standard deviation, SD: 21.1) for women with screen-detected breast cancer (n = 1141) and 62.5 (SD: 21.2) for women with symptomatic breast cancer (n = 1561). Women with screen-detected breast cancer had 3.8 (95 % confidence interval, CI, 2.3, 5.4) and 3.7 (95 %CI 2.1, 5.2) higher HRQoL VAS-scores compared to women with symptomatic breast cancer in the models adjusted for tumor characteristics and treatment, respectively. Women with screen-detected breast cancer and women with symptomatic breast cancer accrued 2.30 and 2.06 QALYs, respectively.</div></div><div><h3>Conclusion</h3><div>Women with screen-detected breast cancer demonstrated higher estimates of long-term HRQoL and QALYs compared to women with symptomatic cancer.</div></div><div><h3>Policy Summary</h3><div>More favorable long-term quality of life outcomes were shown for women diagnosed with breast cancer by organized mammographic screening compared to women diagnosed due to symptoms.</div></div>\",\"PeriodicalId\":38212,\"journal\":{\"name\":\"Journal of Cancer Policy\",\"volume\":\"45 \",\"pages\":\"Article 100631\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-08-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cancer Policy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S221353832500075X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Policy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S221353832500075X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
Long-term quality of life and quality adjusted life years after breast cancer: Impact of detection mode, tumor characteristics and treatment
Background
Health-related quality of life (HRQoL) of breast cancer survivors has been extensively evaluated. However, HRQoL differences for women diagnosed by organized mammographic screening and women diagnosed due to symptoms have been sparsely described. We aimed to compare self-reported long-term HRQoL and quality adjusted life years (QALYs) between women with screen-detected breast cancer and women with symptomatic breast cancer, adjusting for histopathologic tumor characteristics and treatment.
Methods
This study was nested within a cohort of women diagnosed with breast cancer by organized mammographic screening or due to symptoms 2006–2017 who responded a questionnaire measuring HRQoL (VAS, 0–100) and EQ-5D-5L 2019–2020. Responses to EQ-5D-5L were transformed into health utility values using a tariff based on preferences elicited in a national survey. Multivariable linear regression models were used to compare VAS-scores adjusting for tumor characteristics and treatment. QALYs were estimated by summing up the health utility values between the third and the fifth year since breast cancer diagnosis adjusting for breast cancer survival.
Results
Mean HRQoL (VAS) was 66.2 (standard deviation, SD: 21.1) for women with screen-detected breast cancer (n = 1141) and 62.5 (SD: 21.2) for women with symptomatic breast cancer (n = 1561). Women with screen-detected breast cancer had 3.8 (95 % confidence interval, CI, 2.3, 5.4) and 3.7 (95 %CI 2.1, 5.2) higher HRQoL VAS-scores compared to women with symptomatic breast cancer in the models adjusted for tumor characteristics and treatment, respectively. Women with screen-detected breast cancer and women with symptomatic breast cancer accrued 2.30 and 2.06 QALYs, respectively.
Conclusion
Women with screen-detected breast cancer demonstrated higher estimates of long-term HRQoL and QALYs compared to women with symptomatic cancer.
Policy Summary
More favorable long-term quality of life outcomes were shown for women diagnosed with breast cancer by organized mammographic screening compared to women diagnosed due to symptoms.
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