Poor physical health predicts time to additional breast cancer events and mortality in breast cancer survivors

Nazmus Saquib, John P. Pierce, Juliann Saquib, Shirley W. Flatt, Loki Natarajan, Wayne A. Bardwell, Ruth E. Patterson, Marcia L. Stefanick, Cynthia A. Thomson, Cheryl L. Rock, Lovell A. Jones, Ellen B Gold, Njeri Karanja, Barbara A. Parker

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Background: Health-related quality of life has been hypothesized to predict time to additional breast cancer events and all-cause mortality in breast cancer survivors. Methods: Women with early-stage breast cancer (n=2967) completed the SF-36 (mental and physical health-related quality of life) and standardized psychosocial questionnaires to assess social support, optimism, hostility, and depression prior to randomization into a dietary trial. Cox regression was performed to assess whether these measures of quality of life and psychosocial functioning predicted time to additional breast cancer events and all-cause mortality; hazard ratios were the measure of association. Results: There were 492 additional breast cancer events and 301 deaths occurred over a median 7.3 years (range: 0.01-10.8 years) of follow-up. In multivariate models, poorer physical health was associated with both decreased time to additional breast cancer events and all-cause mortality (p trend=0.005 and 0.004, respectively), while greater hostility predicted additional breast cancer events only (p trend=0.03). None of the other psychosocial variables predicted either outcome. The hazard ratios comparing persons with poor (bottom two quintiles) to better (top three quintiles) physical health were 1.42 (95% CI: 1.16, 1.75) for decreased time to additional breast cancer events and 1.37 (95% CI: 1.08, 1.74) for all-cause mortality. Potentially modifiable factors associated with poor physical health included higher body mass index, lower physical activity, lower alcohol consumption, and more insomnia (p<0.05 for all). Conclusion: Interventions to improve physical health should be tested as a means to increase time to additional breast cancer events and mortality among breast cancer survivors.

Original languageEnglish (US)
Pages (from-to)252-259
Number of pages8
JournalPsycho-Oncology
Volume20
Issue number3
DOIs
StatePublished - Mar 2011

Keywords

  • breast cancer
  • oncology
  • physical health
  • survival

ASJC Scopus subject areas

  • Oncology
  • Psychiatry and Mental health
  • Experimental and Cognitive Psychology

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    Saquib, N., Pierce, J. P., Saquib, J., Flatt, S. W., Natarajan, L., Bardwell, W. A., Patterson, R. E., Stefanick, M. L., Thomson, C. A., Rock, C. L., Jones, L. A., Gold, E. B., Karanja, N., & Parker, B. A. (2011). Poor physical health predicts time to additional breast cancer events and mortality in breast cancer survivors. Psycho-Oncology, 20(3), 252-259. https://doi.org/10.1002/pon.1742