Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy

Cahir, Caitriona; Thomas, Audrey Alforque; Dombrowski, Stephan U.; Bennett, Kathleen; Sharp, Linda

doi:10.3390/ijerph14040394

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Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy

Caitriona Cahir

^1,*

Audrey Alforque Thomas

Stephan U. Dombrowski

³,

Kathleen Bennett

¹ and

Linda Sharp

⁴

Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland

Office of Planning & Analysis, University of California, Berkeley, CA 94720, USA

Division of Psychology, University of Stirling, Stirling FK9 4LA, UK

⁴

Institute of Health and Society, Newcastle University, Newcastle NE1 7RU, UK

Author to whom correspondence should be addressed.

Academic Editor: Peter Baade

Int. J. Environ. Res. Public Health 2017, 14(4), 394; https://doi.org/10.3390/ijerph14040394

Received: 27 February 2017 / Revised: 31 March 2017 / Accepted: 5 April 2017 / Published: 7 April 2017

(This article belongs to the Special Issue Geographical Variation in Breast Cancer Outcomes)

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Abstract

The number of breast cancer survivors has increased as a result of rising incidence and increased survival. Research has revealed significant urban–rural variation in clinical aspects of breast cancer but evidence in the area of survivorship is limited. We aimed to investigate whether quality of life (QoL) and treatment-related symptoms vary between urban and rural breast cancer survivors prescribed endocrine therapy. Women with a diagnosis of stages I–III breast cancer prescribed endocrine therapy were identified from the National Cancer Registry Ireland and invited to complete a postal survey (N = 1606; response rate = 66%). A composite measure of urban–rural classification was created using settlement size, population density and proximity to treatment hospital. QoL was measured using the Functional Assessment of Cancer Therapy (FACT-G) and an endocrine subscale. The association between urban–rural residence/status and QoL and endocrine symptoms was assessed using linear regression with adjustment for socio-demographic and clinical covariates. In multivariable analysis, rural survivors had a statistically significant higher overall QoL (β = 3.81, standard error (SE) 1.30, p < 0.01), emotional QoL (β = 0.70, SE 0.21, p < 0.01) and experienced a lower symptom burden (β = 1.76, SE 0.65, p < 0.01) than urban survivors. QoL in breast cancer survivors is not simply about proximity and access to healthcare services but may include individual and community level psychosocial factors. View Full-Text

Keywords: urban; rural; quality of life; breast cancer; survivorship; endocrine therapy

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Cahir, C.; Thomas, A.A.; Dombrowski, S.U.; Bennett, K.; Sharp, L. Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy. Int. J. Environ. Res. Public Health 2017, 14, 394. https://doi.org/10.3390/ijerph14040394

AMA Style

Cahir C, Thomas AA, Dombrowski SU, Bennett K, Sharp L. Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy. International Journal of Environmental Research and Public Health. 2017; 14(4):394. https://doi.org/10.3390/ijerph14040394

Chicago/Turabian Style

Cahir, Caitriona, Audrey Alforque Thomas, Stephan U. Dombrowski, Kathleen Bennett, and Linda Sharp. 2017. "Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy" International Journal of Environmental Research and Public Health 14, no. 4: 394. https://doi.org/10.3390/ijerph14040394

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Urban–Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy

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