Impact of symptom burden on health related quality of life of cancer survivors in a Danish cancer rehabilitation program: A longitudinal study

Figures & data

Table I. Disease-related and demographic characteristics at baseline of 2486 participants in the FOCARE study by cancer site.

	Cancer site
Characteristic	All n (%)	Breast n (%)	Colorectal^a n (%)	Cervix and ovary n (%)	Lung n (%)	Lymphoma n (%)	Head and neck^b n (%)	Prostate n (%)
All (%)	2 486 (100)	1 552 (100)	305 (100)	187 (100)	86 (100)	126 (100)	110 (100)	120 (100)
Gender (%)
Men	373 (15)	4 (0.3)	124 (41)	–	30 (35)	42 (33)	53 (48)	120 (100)
Women	2 113 (85)	1 548 (99.7)	181 (59)	187 (100)	56 (65)	84 (67)	57 (52)	–
Median age (years)	56 (17–90)	54 (25–84)	60 (33–90)	52 (22–85)	60 (25–78)	54 (17–86)	56 (27–75)	67 (49–82)
Year of diagnosis (%)
≤ 2000	233 (9)	177 (11)	6 (2)	23 (12)	3 (3)	17(13)	4 (4)	3 (2)
2001–2005	1 743 (70)	1 095 (71)	198 (65)	136 (73)	67 (78)	88 (70)	87 (79)	72 (60)
2006–2008	467 (19)	256 (17)	95 (31)	27 (15)	16 (19)	16 (13)	13 (12)	44 (37)
Unknown	43 (2)	24 (1)	6 (2)	1 (0)	0 (0)	5 (4)	6 (5)	1 (1)
Tumor stage (%)
High	1 318 (53)	710 (46)	184 (60)	147 (79)	21 (24)	85 (68)	97 (88)	74 (62)
Low	1 151 (46)	842 (54)	121 (40)	40 (21)	48 (56)	41 (32)	13 (12)	46 (38)
Missing	17 (1)				17 (20)

^aIncludes cancers in colon and rectum.

^bIncludes cancers in the oral cavity, salivary glands, thyroid gland, larynx, pharynx, and esophagus.

Table II. Prevalence (percentages) of self-reported cancer-related symptoms and symptom severity among 2 486 participants in the FOCARE study by cancer site.

	Cancer site
Cancer-related symptom %	All (n= 2486)%	Breast (n=1552)%	Colorectal^a (n=305)%	Cervix and ovary (n=187) %	Lung (n=86) %	Lymphoma (n=126)%	Head and neck^b (n=110) %	Prostate (n=120)%
Prevalence of any of the reported symptoms	96	96	91	97	94	98	100	93
Self-reported severity of any of the reported symptoms^c
- Not or a bit bothersome	40	40	55	38	38	31	23	43
- Very bothersome	60	60	45	62	62	69	77	57
Fatigue	65	66	55	69	77	71	74	37
- Very bothersome	18	19	13	20	28	25	26	3
Lack of concentration	45	47	32	53	55	48	55	22
- Very bothersome	8	9	4	12	10	10	12	1
Memory lapses	46	48	35	55	49	49	52	20
- Very bothersome	9	9	5	12	13	12	14	2
Hot flushes	51	63	24	42	24	35	22	41
- Very bothersome	18	25	4	13	6	9	6	11
Sensory disturbance in hands or feet	30	29	30	40	34	49	20	15
- Very bothersome	7	6	10	13	6	16	5	2
Sleep interruption	46	49	32	49	49	51	35	29
- Very bothersome	15	17	6	13	10	16	14	9
Dry mucous membranes	41	44	25	37	28	47	76	19
- Very bothersome	12	12	5	10	7	16	38	2
Digestive problems	22	18	36	38	19	30	36	10
- Very bothersome	9	5	18	21	7	9	13	5
Swelling of limbs	23	29	9	25	19	20	7	6
- Very bothersome	6	8	2	7	1	3	0	1
Dyspnea	29	28	23	34	66	40	33	16
- Very bothersome	5	5	1	6	24	9	6	3
Joint or muscle pain	44	48	30	42	37	53	41	25
- Very bothersome	14	16	6	13	13	17	13	5
Impaired mobility	30	33	19	28	30	35	28	13
- Very bothersome	7	8	4	10	3	7	6	3
Dental problems	14	13	13	12	22	17	37	3
- Very bothersome	5	4	2	3	6	8	23	0
Weight gain or loss	41	44	29	40	41	39	69	22
- Very bothersome	14	15	8	12	8	11	30	5
Altered sense of taste or smell	18	15	16	16	28	29	63	6
- Very bothersome	4	3	2	4	6	7	28	1
Urinary problems	14	10	20	16	10	9	13	45
- Very bothersome	3	3	4	5	3	2	2	5
Sexual problems	39	37	35	45	30	42	44	67
- Very bothersome	12	10	9	17	10	13	11	33
Potency problems	8	–	17	–	5	17	14	76
- Very bothersome	7	–	17	–	9	17	15	73

Percentages are rounded to the nearest whole number.

^aIncludes cancers in colon and rectum.

^bIncludes cancers in the oral cavity, salivary glands, thyroid gland, larynx, pharynx, and esophagus.

^cAmong 2 379 participants who reported having one or more of 18 predefined symptoms.

Figure 1. Mean scores on EORTC QLQ-C30 quality of life subscale at baseline and at 1-, 6-, and 12-month follow-up by cancer site B: Baseline; F1: 1 month follow-up; F2: 6 month follow-up; F3: 12 month follow-up.

Figure 2. Mean score on EORTC QLQ-C30 functioning subscales at baseline and at 1-, 6-, and 12-month follow-up by cancer site B: Baseline; F1: 1 month follow-up; F2: 6 month follow-up; F3: 12 month follow-up.

Table III. Multivariate linear regression models of the association between tumor stage (high vs. low) and self-reported symptom severity (high vs. low) and baseline values of EORTC QLQ-C30 subscale (model 1) and change between baseline and the 12-month follow-up (model 2) of 2 486 participants in the FOCARE study by cancer site.

	Breast		Colorectal		Cervix and ovary		Lung		Lymphoma		Head and neck		Prostate
EORTC QLQ C30 subscale	Model 1^a	Model 2^b	Model 1^a	Model 2^b	Model 1^a	Model 2^b	Model 1^a	Model 2^b	Model 1^a	Model 2^b	Model 1^a	Model 2^b	Model 1^a	Model 2^b
Global QoL
High stage^c	−3.5	−0.8	−5.1*	+1.5	+4.4	−8.7*	+12.6*	+4.2	+6.9	+4.3	+0.8	−1.5	−3.6	−10.0*
Symptom reported as severe^d	−10.2*	−5.1*	−11.7*	+4.9	−15.9*	−5.9	−15.6*	−12.5*	−15.7*	+3.1	−11.9*	−1.6	−15.2*	−0.2
Physical functioning
High stage^c	−1.4	−0.4	−6.6*	+2.0	+2.8	−7.2	+9.9*	−3.9	+6.9	+2.9	+4.5	−2.6	+2.8	−4.8
Symptom reported as severe^d	−7.4*	−3.0*	−3.0*	+0.9	−9.8*	+6.1*	−7.6	−9.6*	−9.9*	−3.0	−9.5*	+3.7	−7.9*	+3.1
Social functioning
High stage^c	−0.1	−3.0*	−14.7*	−2.8	+3.9	−10.8*	+6.0	+4.2	+6.1	+0.8	+11.1	+14.7	+3.9	−4.9
Symptom reported as severe^d	−13.0*	−7.2*	−20.6*	+0.6	−18.5*	−8.6*	−21.1*	−9.2	−14.9*	−9.2*	−19.2*	−1.1	−13.6*	−8.2
Emotional functioning
High stage^c	−0.6	−0.3	−4–3	−0.8	+2.9	−1.9	+17.7*	+8.3	+1.9	+4.7	+5.0	−9.2	−4.1	+3.4
Symptom reported as severe^d	−10.6*	−4.7*	−12.3*	+1.9	−13.8*	−4.4	−18.8*	−14.6*	−12.9*	−4.4	−17.0*	−4.5	−8.5*	−0.2
Cognitive functioning
High stage^c	−1.6	−0.9	−6.5*	+0.2	+9.6*	+0.9	+20.1*	−3.2	+2.4	+9.1*	+12.5	−2.6	−0.3	+2.2
Symptom reported as severe^d	−14.2*	−4.0*	−14.3*	+3.2	−15.6*	+4.8	−18.4*	−7.2	−13.2*	−3.2	−10.8	−2.3	−9.6*	−3.1

*P-values < 0.05; negative differences (−) on the scales represents poorer scores, positive differences (+) on the scales represents improvement in functioning.

^aMultivariate linear regression model of difference in baseline level of the given functional scale, adjusted for time since diagnosis, gender, age, education.

^bMultivariate linear regression model of change between baseline level and the 12 months follow-up, adjusted for time since diagnosis, gender, age, education and baseline score of the outcome variable.

^cHigh stage relative to low stage.

^dSelf-reported high severity relative to low severity of reported cancer related symptom.