3 years ago

The impact of bladder cancer on health-related quality of life

Lloyd J. Edwards, Laura C. Pinheiro, Angela B. Smith, Matthew E. Nielsen, Hung-Jui Tan, Byron Jaeger, Bryce B. Reeve
Objectives To identify HRQOL changes before to after diagnosis in older adults with bladder cancer and to compare their changes to non-cancer controls. Patients and Methods Data from the Surveillance, Epidemiology, and End Results registries were linked with Medicare Health Outcomes Survey (MHOS) data. Medicare beneficiaries >= 65 years from 1998-2013 who were diagnosed with bladder cancer between baseline and follow-up MHOS were matched with non-cancer controls using propensity scores. Linear mixed models were used to estimate predictors of HRQOL changes. Results After matching, 535 bladder cancer patients (458 non-invasive and 77 invasive) and 2770 non-cancer controls were identified. Both non-invasive and invasive cases (respectively) reported significant declines in HRQOL over time when compared to controls: Physical Component Summary (-2 and -5.3 vs. -0.4), Bodily Pain (-1.9 and -3.6 vs. -0.7), Role Physical (-2.7 and -4.7 vs. -0.7), General Health (-2.4 and -6.1 vs. 0), Vitality (-1.2 and -3.5 vs. -0.1) and Social Functioning (-2.1 and -5.7 vs. -0.8). All scores range from 0 to 100. When stratified by time since diagnosis, HRQOL improved over 1 year for some domains (Role Physical) but remained lower across most domains. Conclusions After diagnosis, bladder cancer patients experienced significant declines in physical, mental, and social HRQOL relative to controls. Decrements were most pronounced among individuals with invasive disease. Identifying methods to better understand and address HRQOL decrements among bladder cancer patients is needed. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/bju.14047

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