No association between vitamin A or retinol intake and the risk of hip or total fractures was observed in postmenopausal women. Only a modest increase in total fracture risk with high vitamin A and retinol intakes was observed in the low vitamin D-intake group.
Purpose
Distress and reduced quality of life (QOL) are common among people with cancer.
No study has compared these variables after breast cancer diagnosis to pre-cancer
diagnosis levels.
Methods
Data on women with breast cancer 50 years of age or older (n=6949) were
analyzed from the Women's Health Initiative (1993-2013). Health-related QOL (physical
function, mental health) was measured using Rand-36. Depressive symptoms were measured
with the 6-item Center for Epidemiologic Studies Depression. Assessments occurred before
and after the cancer diagnosis. Hierarchical linear modeling compared pre-cancer QOL and
depressive symptoms to levels post-diagnosis and tested whether pre-cancer physical
activity, stressful life events, sleep disturbance, and pain predicted post-diagnosis
outcomes.
Results
Compared with pre-cancer levels, depressive symptoms increased (20.0% increase
at 0-6 months, 12.9% increase at 6-12 months), while physical function (−3.882
points at 0-6 months, −3.545 at 6-12 months) and mental health decreased
(−2.899 points at 0-6 months, −1.672 at 6-12 months) in the first year
after diagnosis (p's<.01). Depressive symptoms returned to pre-cancer levels
after 10 years but QOL remained significantly lower. At more than 10 years
post-diagnosis, physical function was 2.379 points lower than pre-cancer levels
(p<0.01) while mental health was 1.922 points lower (p<0.01). All
pre-cancer predictors were associated with all outcomes. Pain predicted uniquely greater
decreases in physical function post-diagnosis.
Conclusions
Depressive symptoms increased and QOL decreased following breast cancer
diagnosis compared with pre-cancer levels, particularly in the first year.
Implications for Cancer Survivors
QOL may remain lower for years after breast cancer diagnosis, though decreases
are small.
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