Background: Cancer survivors are a large and growing population worldwide. While some survivors can live healthy and productive life, many experiences poorer long-term health outcomes stemming from the diagnosis and/or treatment of cancer. Optimizing health-related quality of life (HRQOL) is one of the key goals of cancer treatment and life decisions. However, studies are limited in identifying the trajectories of HRQOL based on the longitudinal patient-reported outcome.
Aims: This study aims to identify distinct trajectories of HRQOL among women cancer survivors who survived more than 3 years after a cancer diagnosis, and to examine survivors’ profiles of the different trajectory groups.
Methods: We analyzed data from a large cohort (n=14,715; born: 1946-51) of the Australian Longitudinal Study on Women’s Health (ALSWH) linked to the Australian Cancer Database (ACD) to ascertain incident cancer cases, between 1996 (baseline) and 2019 (9th follow-up) when the cohort was aged 45-50 and 68-73 years, respectively. HRQOL was measured using the Short Form-36 (SF-36) questionnaire in the surveys completed after the diagnosis of cancer. Group-based multi-trajectory modeling was applied to identify distinct trajectory groups and multinomial logistic regression was performed to identify the survivors’ characteristics associated with membership in different trajectory groups.
Results: Of the 2657 (21%) women diagnosed with an incident cancer during follow-up of the cohort, this study included 1451 who survived more than three years and participated in at least one survey after diagnosis of cancer. Three distinct trajectory groups were identified over time with group 1 (227, 21%) having low HRQOL across all domains, group 2 (408, 37%) having moderate to high HRQOL, and group 3 (470, 42%) having high HRQOL across all domains.
Conclusion: Our findings will enhance the understanding of long-term health outcomes following diagnosis and treatment of cancer, by identifying the trajectory groups and life experience over time.