Quality of life of long-term survivors of non-small-cell lung cancer.
OBJECTIVE
To describe the quality of life (QOL) among survivors of non-small-cell lung cancer (NSCLC).


METHODS
One hundred forty-two 5-year minimum self-reported disease-free survivors of NSCLC completed QOL instruments (QOL-Survivor and Medical Outcomes Study 36-Item Short Form [SF-36]) and assessments of emotional distress (Center for Epidemiologic Studies Depression Scale [CES-D]), comorbid disease, and tobacco use. Pulmonary function was assessed with a hand-held spirometer. Multivariate regression methods were used on total QOL-Survivor scores and physical (PC) and mental (MC) component scores of the SF-36.


RESULTS
The majority (71%) of survivors described themselves as hopeful, and 50% viewed the cancer experience as contributing to positive life changes (QOL-Survivor). Comorbidity was common (60% >or= one condition); 22% had distressed mood (CES-D >or= 16). Most were former smokers (76%); 13% continued to smoke. Half had moderate/severe pulmonary distress (forced expired volume in 1 second [FEV1] < 70% of predicted). Regression models including the set of variables (age, sex, living alone, education, smoking status, pulmonary function category, distressed mood, time since diagnosis, and comorbidity) accounted for 37%, 48%, and 29% in the QOL-total, MC, and PC scores, respectively. Primary predictors of lower QOL scores were white ethnicity and distressed mood (CES-D >or= 16) (34% of the variance explained). The primary predictor of lower MC scores was distressed mood (R(2) = 0.45). Lower PC scores were associated with older age, living alone, FEV1 less than 70% of predicted, distressed mood, time since diagnosis, and more comorbid diseases (R(2) = 0.28).


CONCLUSIONS
These findings provide the first description of the QOL of long-term survivors of lung cancer. Risk factors for poorer QOL are strongly linked to distressed mood, which is a potential target for intervention.
Sarna
Linda
L
School of Nursing, University of California Los Angeles, Los Angeles, CA 90095-6918, USA. lsarna@sonnet.ucla.edu
Padilla
Geraldine
G
Holmes
Carmack
C
Tashkin
Donald
D
Brecht
Mary Lynn
ML
Evangelista
Lorraine
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012044:Regression Analysis; D013147:Spirometry; D011795:Surveys and Questionnaires; D017741:Survivors