Health-related quality of life in breast cancer patients in low-and-middle-income countries in Asia: a systematic review

Abstract

IntroductionBreast cancer remains one of the major cancers worldwide. In Asia, breast cancer is leading both incidence and mortality rates. Health-related quality of life (HRQoL) studies play an important role in clinical treatment. This systematic review aimed to summarize the evidence of HRQoL and associated factors among patients with breast cancer in low-and-middle-income countries (LMICs) in Asia.MethodPerformed according to PRISMA guidelines for systematic review, the studies were searched from three databases (PubMed, Cochrane, Scopus) up to November 2020. The studies which met the predefined eligibility criteria were selected, extracted, and assessed the quality according to the Newcastle—Ottawa Scale (NOS) tool.Results and DiscussionA total of 2,620 studies were searched on the three databases, of which 28 met the selection criteria, then, were included in the systematic review. The Global Health Status (GHS) score of breast cancer patients based on the EORTC QLQ-C30 questionnaire ranged from 56.32 ± 25.42 to 72.48 ± 15.68. The overall HRQoL scores using the FACT-G and FACT-B instruments ranged from 60.78 ± 13.27 to 82.23 ± 12.55 and from 70.29 ± 13.33 to 108.48 ± 19.82, respectively. Factors affecting HRQoL of patients with breast cancer included age, education level, income, marital status, lifestyle, tumor stage, method, and treatment duration. Patient's income showed a consistent effect on HRQoL while the remaining factors reported inconsistent findings across the studies. In conclusion, the HRQoL of breast cancer patients in LMICs in Asia was low and affected by several sociodemographic factors which should be studied more in future research.

Health-state utility of patients with HER2-positive breast cancer in Vietnam: A multicenter cross-sectional study

“…However, in several studies in China and Japan, younger patients had lower health-related quality of life by reason of being under a lot of pressure and stress [39][40][41]. With regard to patients' monthly income and education level, our findings were in line with the results of a systematic review: those with higher income and education levels had higher health-related quality of life [36]. Patients with low income and low education levels may be unable to afford the treatment costs and not comprehend the crucial role of treatment adherence, thereby lowering the treatment's effectiveness and efficacy.…”

“…In Asia, breast cancer patients receiving chemotherapy, having comorbidities, less social support, and more unmet needs had poorer health-related quality of life [ 34 ]. In low- and middle-income countries in Asia, breast cancer patients’ health-related quality of life was associated with their age, marital status, education level, income, stage of the tumor, method, treatment duration, and lifestyle [ 36 ]. Similar to our results, the poor health-related quality of life and health-state utility of breast cancer patients with old age, low education level, and low income per month were also found among patients in other countries, such as China, Korea, and India [ 13 , 24 , 27 , 32 , 37 , 38 ].…”