Impact of public vs. private insurance coverage on quality of life of women with early-stage estrogen receptor-positive breast cancer.
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Laperche-Santos Danielle, Assad-Suzuki Daniele, Resende Heloisa, Moura Fernanda Cesar, Oliveira Sulene Cunha Sousa, Shimada Andrea Kazumi, Arakelian Renata, Galvão Anna Luiza Zapalowski, de Souza Bruno Santos Wance, Custodio Amanda Guimarães Castro, de Andrade Monalisa Ceciliana Freitas Moreira, Bittencourt Yuri Cardoso Rodrigues Beckedorff, Magalhães Maria Cristina Figueroa, de Pádua Souza Cristiano, Paiva Carlos Eduardo, Signorini Poliana Albuquerque, Pereira Daniela Jessica, Nogueira-Rodrigues Angélica, Rosa Daniela Dornelles, Barroso-Sousa Romualdo
Аннотация
METHODS: We performed a cross-sectional study among women with early-stage estrogen receptor-positive (ER +) invasive carcinoma of the breast in Brazil. Eligible patients who had received locoregional care and had undergone adjuvant ET for more than 6 months were contacted in person during clinic visits. The EORTC QLQ-C30-V3 and QLQ-BR23 scales were used as questionnaires to assess the QOL of patients.
RESULTS: From June 2021 to March 2024, 774 women with ER + early-stage breast cancer from 14 Brazilian institutions were contacted. A total of 347 women (44.8%) were treated at private institutions. The mean age was 56.5 years (SD 11.9). The median duration of ET use was 3.2 years (SD, 2.1). Multivariate regression analysis revealed that treatment at a public institution was a significant predictor of higher nausea and vomiting scores (p = 0.042), pain (p = 0.0008), financial difficulty (p < 0.0001), arm symptoms (p < 0.0001), and breast symptoms (p < 0.0001).
CONCLUSION: In this cohort, patients treated at public institutions had lower QOL. Younger age (< 60 years), presence of comorbidities, and ovarian suppression associated with ET were key predictors of poor QOL. These findings provide insights for guiding the development of tailored interventions for the Brazilian population.