Journal
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Volume 14, Issue 4, Pages -Publisher
MDPI
DOI: 10.3390/ijerph14040394
Keywords
urban; rural; quality of life; breast cancer; survivorship; endocrine therapy
Funding
- Health Research Board Ireland [ICE-2011-9, RL-2015-1579]
- Health Research Board (HRB) [ICE-2011-9, RL-2015-1579] Funding Source: Health Research Board (HRB)
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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 (beta = 3.81, standard error (SE) 1.30, p < 0.01), emotional QoL (beta = 0.70, SE 0.21, p < 0.01) and experienced a lower symptom burden (beta = 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.
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