Quality of life in a prospective cohort of elderly women with and without cancer

BACKGROUND: Quality of life (QOL) is an important issue for cancer survivors; few studies are able to consider elderly populations, address long-term survival (≥5 years), examine different cancers, or include a valid noncancer comparison group. METHODS: The authors assessed QOL in 2004 among women participating in the Iowa Women's Health Study, a prospective cohort of older women followed since 1986. Cancer occurrence during follow-up was identified through the State Health Registry of Iowa. The authors compared unadjusted, and age- and comorbidity-adjusted mean scores for 8 Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) scales among women with and without cancer by all cancer types, stage, and survival. Analyses were repeated after excluding women who developed a second primary cancer or reported cancer treatment in 2004. RESULTS: Among 17,385 respondents aged 71-89 years, 2717 (16.6%) had been diagnosed with cancer since 1986. Compared with women without cancer, survivors fared worse on the General Health scale, regardless of cancer type (except colorectal), stage, or survival. Except for lower scores among the longest survivors, Mental Health scores did not differ significantly between women with and without cancer. Women with genitourinary, lung, hematopoietic, lymphoma, or other gastrointestinal cancers, with cancer at the distant stage, or who survived at least 10 years consistently experienced significantly lower QOL scores than cancer-free women for most scales. CONCLUSIONS: Differences in QOL depended upon the specific SF-36 scale and which aspect of cancer survivorship was examined. These findings underscore the complexity of factors contributing to QOL among cancer survivors.