title: Quality of life in long-term and very long-term cancer survivors versus population controls in Germany.
abstract: BACKGROUND
  With the increasing number and diversity of cancer survivors, studies of survivors' physical, emotional, and social health are of growing importance. While there is a growing body of literature on the quality of life (QoL) of cancer patients during the early years past diagnosis, less is known regarding QoL in long-term survivors (LTS) (5 + years past diagnosis) and particularly in very long-term survivors (VLTS) (10 + years past diagnosis). The objective of our study is to: (1) compare QoL of long-term cancer survivors and population norms; and (2) assess whether any deficits in QoL of survivors observed 5-10 years past diagnosis persist beyond the 10th year past diagnosis.
  
  
  METHODS
  In total 6952 long-term cancer survivors (5-16 years past diagnosis of breast, colorectal, or prostate cancer) from Germany recruited in the context of the population-based CAESAR + study were compared with 1878 population-based controls without a history of cancer. QoL was assessed with the EORTC QLQ-C30. Differences in QoL between survivors and controls were assessed via multiple regression while controlling for age, gender, education, and case mix for survivors 5-9 years and 10 + years past diagnosis separately.
  
  
  RESULTS
  Overall QoL in long-term cancer survivors was comparable to population norms but specific deficits in social, role, emotional, cognitive, and physical functioning and symptoms such as insomnia, fatigue, dyspnea, constipation, diarrhea, and financial difficulties were more prevalent in LTSs. Detriments in QoL persisted during the observation period and affected particularly cancer survivors at younger ages (<50 years). Non-significant aggravations in QoL with longer time since diagnosis were observed in very young and very old cancer survivors.
  
  
  CONCLUSIONS
  Detriments in health-related quality of life persist over more than a decade and affect predominantly younger patients. Improvements both in early and long-term follow-up care of cancer survivors seem warranted.
authors.affiliation: a Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.|b German Cancer Research Center (DKFZ), Office of Cancer Survivorship Research , Heidelberg , Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Arndt
authors.affiliation: a Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Koch-Gallenkamp
authors.affiliation: a Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Lina
authors.initials: L
authors.lastname: Jansen
authors.affiliation: c Cancer Registry of North Rhine-Westphalia , Münster , Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Bertram
authors.affiliation: d Bremen Cancer Registry , Leibniz Institute for Prevention Research and Epidemiology - BIPS , Bremen , Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Eberle
authors.affiliation: e Saarland Cancer Registry , Saarbrücken , Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: f Hamburg Cancer Registry , Hamburg , Germany.
authors.forename: Sieglinde
authors.initials: S
authors.lastname: Schmid-Höpfner
authors.affiliation: g Institute of Social Medicine and Epidemiology, University Lübeck , Lübeck , Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Waldmann
authors.affiliation: h Cancer Registry Rhineland-Palatinate , Mainz , Germany.
authors.forename: Sylke Ruth
authors.initials: SR
authors.lastname: Zeissig
authors.affiliation: a Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg , Germany.|i Division of Preventive Oncology , German Cancer Research Center (DKFZ) , Heidelberg , Germany.|j German Cancer Consortium (DKTK) , German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000523:psychology*; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*