title: Association between Time since Cancer Diagnosis and Health-Related Quality of Life: A Population-Level Analysis.
abstract: To examine the association between time since cancer diagnosis and health-related quality of life (HRQOL) among cancer survivors in remission.
  
  
  
  Analyzing data from 3,610 cancer survivors and 59,539 individuals without cancer in the Medical Expenditure Panel Survey, we examined the relationship between time since cancer diagnosis and HRQOL, taking remission status into account and controlling for patients' demographic characteristics and comorbidities. HRQOL measurements included the six-dimensional health state short form (derived from 36-item short form health survey) (SF-6D) utility scores, the physical component summary score, and the mental component summary score.
  
  
  
  The relationship between time since cancer diagnosis and HRQOL varied substantially across cancer types. Compared with individuals without cancer, survivors of breast, prostate, or poor-prognosis cancer had statistically lower SF-6D scores within 2 years of diagnosis (-0.044, -0.062, and -0.088, respectively). Breast cancer survivors had SF-6D scores similar to those of individuals without cancer after 2 years, as did patients with poor-prognosis cancer after 5 years. Nevertheless, even after a period of 10 years, survivors of prostate or cervical cancer had a lower level of SF-6D scores (-0.027 and -0.042, respectively). The comparisons of physical health between cancer survivors and individuals without cancer were similar to those of SF-6D. In contrast, most cancer survivors did not experience poorer mental health; survivors of prostate or cervical cancer, however, had lower mental component summary scores after 10 years of diagnosis.
  
  
  
  The level of HRQOL among cancer survivors depends on time since cancer diagnosis and cancer type. Some cancer survivors have lower HRQOL after a decade of diagnosis, even in remission.
authors: Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA. Electronic address: shiyi.wang@yale.edu.
authors: Shi-Yi
authors: SY
authors: Wang
authors: Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA; Schulich School of Business, York University, Toronto, Ontario, Canada.
authors: Sylvia H
authors: SH
authors: Hsu
authors: Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT, USA; Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors: Cary P
authors: CP
authors: Gross
authors: Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT, USA; Section of Medical Oncology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors: Tara
authors: T
authors: Sanft
authors: Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT, USA; Department of Health Policy and Management, Yale University School of Public Health, New Haven, CT, USA.
authors: Amy J
authors: AJ
authors: Davidoff
authors: Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA.
authors: Xiaomei
authors: X
authors: Ma
authors: Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT, USA; Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA.
authors: James B
authors: JB
authors: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D011788:Quality of Life; D013997:Time Factors; D055815:Young Adult
keywords: SF-6D; cancer survivors; health-related quality of life (HRQOL); time-sensitive differences