Magnitude and Temporal Variations of Socioeconomic Inequalities in the Quality of Life After Early Breast Cancer: Results From the Multicentric French CANTO Cohort-Reference-Cited by-同舟云学术

Magnitude and Temporal Variations of Socioeconomic Inequalities in the Quality of Life After Early Breast Cancer: Results From the Multicentric French CANTO Cohort

Published:2024-08-20 Issue:24 Volume:42 Page:2908-2917
ISSN:0732-183X
Container-title:Journal of Clinical Oncology
language:en
Short-container-title:JCO

Author:

Sandoval José Luis¹²^ORCID,Franzoi Maria Alice³^ORCID,di Meglio Antonio³⁴^ORCID,Ferreira Arlindo R.⁵^ORCID,Viansone Alessandro⁴,André Fabrice³⁴^ORCID,Martin Anne-Laure⁶^ORCID,Everhard Sibille⁶^ORCID,Jouannaud Christelle⁷,Fournier Marion⁸,Rouanet Philippe⁹^ORCID,Vanlemmens Laurence¹⁰,Dhaini-Merimeche Asma¹¹^ORCID,Sauterey Baptiste¹²^ORCID,Cottu Paul¹³^ORCID,Levy Christelle¹⁴,Stringhini Silvia¹,Guessous Idris¹,Vaz-Luis Ines³¹⁵^ORCID,Menvielle Gwenn³^ORCID

Affiliation:

1. Unit of Population Epidemiology, Division of Primary Care, Department of Health and Community Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland

2. Division of Oncology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland

3. Unit of Molecular Predictors and New Targets in Oncology, INSERM, Gustave Roussy Institute, University Paris Saclay, Villejuif, France

4. Medical Oncology Department, Gustave Roussy Institute, Villejuif, France

5. Universidade Católica Portuguesa, Lisbon, Portugal

6. UNICANCER, Direction des Data et des Partenariats, Le Kremlin-Bicêtre, France

7. Institut Godinot, Reims, France

8. Institut Bergonié, Bordeaux, France

9. Institut régional du Cancer de Montpellier—Val d'Aurelle, Montpellier, France

10. Centre Oscar Lambret, Lille, France

11. Institut de Cancérologie de Lorraine—Alexis Vautrin, Vandoeuvre lès Nancy, France

12. Institut de Cancérologie de L'ouest—Site Angers, Angers, France

13. Institut Curie, Paris, France

14. Centre François Baclesse, Caen, France

15. Interdisciplinary department for the Organization of Patient Pathways (DIOPP), Gustave Roussy Institute, Villejuif, France

Abstract

PURPOSE Socioeconomic status (SES) influences the survival outcomes of patients with early breast cancer (EBC). However, limited research investigates social inequalities in their quality of life (QoL). This study examines the socioeconomic inequalities in QoL after an EBC diagnosis and their time trends. PATIENTS AND METHODS We used data from the French prospective multicentric CANTO cohort (ClinicalTrials.gov identifier: NCT01993498 ), including women with EBC enrolled between 2012 and 2018. QoL was assessed using the European Organisation for Research and Treatment of Cancer QoL Core 30 questionnaire (QLQ-C30). summary score at diagnosis and 1 and 2 years postdiagnosis. We considered three indicators of SES separately: self-reported financial difficulties, household income, and educational level. We first analyzed the trajectories of the QLQ-C30 summary score by SES group. Then, social inequalities in QLQ-C30 summary score and their time trends were quantified using the regression-based slope index of inequality (SII), representing the absolute change in the outcome along socioeconomic gradient extremes. The analyses were adjusted for age at diagnosis, Charlson Comorbidity Index, disease stage, and type of local and systemic treatment. RESULTS Among the 5,915 included patients with data on QoL at diagnosis and at the 2-year follow-up, social inequalities in QLQ-C30 summary score at baseline were statistically significant for all SES indicators (SIIfinancial difficulties = –7.6 [–8.9; –6.2], SIIincome = –4.0 [–5.2; –2.8]), SIIeducation = –1.9 [–3.1; –0.7]). These inequalities significantly increased (interaction P < .05) in year 1 and year 2 postdiagnosis, irrespective of prediagnosis health, tumor characteristics, and treatment. Similar results were observed in subgroups defined by menopausal status and type of adjuvant systemic treatment. CONCLUSION The magnitude of preexisting inequalities in QoL increased over time after EBC diagnosis, emphasizing the importance of considering social determinants of health during comprehensive cancer care planning.

Publisher

American Society of Clinical Oncology (ASCO)

Link

https://ascopubs.org/doi/pdfdirect/10.1200/JCO.23.02099

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