Comparison of health-related quality of life trajectories in older breast cancer survivors and noncancerous controls over 10 years: A SEER-MHOS analysis.

Purpose: This study analyzed the long-term effects of cancer on the health-related quality of life (HRQOL) of older breast cancer survivors for 10 years, including a control group to distinguish between the impacts of cancer treatment and aging.

Methods: The SEER-MHOS data resource was used in the analysis. Cases were 674 older women diagnosed with breast cancer in 1998-2015 at age 65 and older and participated in Medicare Health Outcomes Survey within 24 months before their cancer diagnosis and at least once within 10 years of post-diagnosis. Propensity score-matched controls (n = 674) were randomly selected from noncancer cohorts. Participants reported their HRQOL using SF-36/VR-12. Repeated measures two-way analysis of variance was used to assess the effects of time, group, and the interaction between time and group on long-term HRQOL trajectory up to 10 years of follow-up.

Results: At baseline, cases fared worse than controls in all HRQOL domains. Over time, physical component summary, physical functioning, general health, role limitation due to physical health, bodily pain, social functioning, and vitality worsened (P < 0.05) with significant differences between the groups at some points (P < 0.05), while mental component summary, mental health, and role limitation due to emotional problems remained relatively constant (P ≥ 0.05). Cases had consistently lower general health than controls with a greater gap at the end of observation.

Conclusions: Both cases and controls experienced physical HRQOL deterioration, but relatively stable mental HRQOL over 10 years.

Implications For Cancer Survivors: Early interventions focusing on physical health are warranted to maintain HRQOL among older women diagnosed with breast cancer.