Differences in quality of life between American and Chinese breast cancer survivors

Abstract

Objective It has been speculated that cancer survivors in Asia may have lower quality of life (QOL) compared with their western counterparts. However, no studies made international comparisons in QOL using a comprehensive measure. This study aimed to compare Chinese breast cancer survivors’ QOL with United States (US) counterparts and examine if demographic and medical factors were associated with QOL across groups. Method The sample consisted of 159 breast cancer patients (97 Chinese and 62 US) who completed the Functional Assessment for Cancer Therapy Breast Cancer Scale (FACT-B) before the start of radiotherapy in Shanghai, China and Houston, US. Results Higher income was associated with higher QOL total scores in both Chinese and American cancer patients, but QOL was not significantly associated with other factors including age, education, disease stage, mastectomy and chemotherapy. Consistent with hypotheses, compared to their US counterparts, Chinese breast cancer survivors reported lower QOL including FACT-G total scores and all four sub-dimensions including Functional Well-being (FWB), Physical Well-being (PWB), Emotional Well-being (EWB) and Social Well-being (SWB); they also reported more breast cancer specific concerns (BCS). Differences were also clinically significant for FACT-G total scores and the FWB subscale. After controlling for demographic and medical covariates, these differences remained except for the SWB and BCS. Furthermore, Chinese breast cancer survivors receiving chemotherapy reported significantly lower FACT-G scores than those who did not, but this difference did not emerge among US breast cancer survivors. Discussion Chinese breast cancer survivors reported poorer QOL on multiple domains compared to US women. Findings indicate that better strategies are needed to help improve the QOL of Chinese breast cancer survivors, especially those who underwent chemotherapy.

Depressive symptoms and positive affect in Chinese and United States breast cancer survivors: a cross-cultural comparison

“…Regarding QOL, Chinese women reported statistically and clinically significantly lower QOL on the FACT-B total score as well as statistically significantly lower QOL on all sub-scales compared to US women (Table 2; details on these comparisons have been previously reported elsewhere [32]). In both samples, lower level of income was significantly associated with lower QOL ( p < 0.05).…”

The predictors of poor quality of life in a sample of Saudi women with breast cancer

“…A study in Saudi Arabia showed breast cancer survivors reported a low overall global QoL, 29 whereas Chinese and U.S. breast cancer survivors reported poor QoL. 41 A study in Sweden reported poorer QoL in newly diagnosed breast cancer patients when compared with the normative population. 42 Our study suggested that employment was a negative predictor of role limitations due to emotional problems, vitality, and emotional well-being.…”

Prostate cancer‐specific anxiety and the resulting health‐related quality of life in couples

“…Their results indicated that the HRQOL of their spouses is influenced by their own health status, anxiety/depression and relationship quality rather than the factors that relate to the people. Previous studies on other types of cancer in China and the United States have shown that the overall HRQOL of people with breast cancer in China is lower than that of people with breast cancer in the United States (Lu et al., ). Moreover, the low positive emotions of people with breast cancer in China have a greater influence on their emotional well‐being than do the low positive emotions of people with breast cancer in the United States (Milbury et al., ).…”

“…To date, however, few studies have analyzed the relationship between prostate cancer-specific anxiety and HRQOL in people and their spouses together. (Lu et al, 2016).…”