Worry about Breast Cancer Recurrence: A Population-based Analysis

Abstract

As more patients with breast cancer survive treatment, the importance of their long-term quality of life is increasing. One important concern for many survivors is fear of recurrence. To better understand worry about recurrence, we conducted a population-based statistical analysis. The National Health Interview Survey (NHIS) is the largest annual source of health information for the U.S. population. We obtained data from the 2010 survey, which asked breast cancer survivors about their fear of recurrence and quality of life. Data were analyzed using SUDAAN software. The 2010 NHIS sample represented 2,668,697 breast cancer survivors. On univariate analysis, worry about recurrence was correlated with current age ( P = 0.03) and radiation therapy ( P = 0.04). Worry was strongly associated with perceived risk of recurrence ( P < 0.01) and decreased overall quality of life ( P < 0.01) as well as lower self-reported physical ( P < 0.01) and mental ( P < 0.01) health and poor satisfaction with social activities and relationships ( P < 0.01). On multivariate analysis, worry was not independently associated with decreased quality of life ( P = 0.09). However, those who “always worried” about recurrence had a lower quality of life (odds ratio, 0.06; 95% confidence interval, 0.01 to 0.45). Worry about recurrence among breast cancer survivors is associated with age and radiation therapy and is correlated with self-reported physical health, mental health, social relationships, and overall quality of life. It is a significant predictor of decreased quality of life in those who worry the most. Screening for worry about recurrence is an important measure for the improvement of quality of life among breast cancer survivors.