Factors influencing quality of life over five years post-diagnosis in breast cancer survivors: Results from the E3N-Generations cohort.

INTRODUCTION

Quality of life (QoL) of cancer survivors may be affected in the long term by the severity of the cancer and its treatment. We aimed to measure QoL and to identify factors associated with a lower QoL in breast cancer survivors (BCS) more than five years after cancer diagnosis.

METHODS

We conducted a cross-sectional study (October 2020-December 2021) among BCS participating in the French population-based E3N-Generations prospective cohort. QoL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) version 3. Self-administered questionnaires were used to collect data on sociodemographic and health-related factors, lifestyle habits, and post-traumatic growth.

RESULTS

The study included 1,540 BCS aged 70-95 years. The mean EORTC QLQ-C30 scores were 82.6±17.42, 85.89±22.76, 75.81±21.41, 81.26±19.42, 89.24±21.12 and 67.75±17.42 for physical/role/emotional/cognitive/social functioning and general health status (GHS)/QoL, respectively. Factors such as fatigue, depression, pain, anxiety, comorbidity, financial difficulties and alcohol consumption, older age, dyspnoea, high BMI, low regular physical activity and low education were associated with problematic functioning (below clinically significant thresholds) and GHS/QoL scores.

CONCLUSIONS

Behavioural changes could improve modifiable factors (high BMI, low regular physical activity) and have a positive impact on functioning and QoL. Better management of anxiety, depression, fatigue, pain, sleep and digestive disorders, cardiovascular, neurological diseases and diabetes could help improve QoL in BCS.

IMPLICATIONS FOR CANCER SURVIVORS: Long-term surveillance of BCS and early management of cancer sequelae through targeted counselling and interventions can prevent deterioration in survivors' functioning and QoL over time.