1Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
2Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
3Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea
4Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
5Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
6Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
7Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
8Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
Copyright © 2022 by the Korean Cancer Association
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ethical Statement
This study was approved by the National Cancer Center institutional review board (IRB approval number: NCC2019-0281). All participants gave their consent to participate by signing an informed consent form.
Author Contributions
Conceived and designed the analysis: Tran TXM, Jung SY, Lee EG, Kim NY, Kang D, Cho J, Lee E, Chang YJ, Cho H (Hyunsoon Cho).
Collected the data: Tran TXM, Cho H (Heeyoun Cho), Kim NY, Shim S, Kim HY, Chang YJ.
Contributed data or analysis tools: Tran TXM, Jung S, Lee EG, Kang D, Cho J, Lee E, Chang YJ, Cho H (Hyunsoon Cho).
Performed the analysis: Tran TXM, Cho H (Hyunsoon Cho).
Wrote the paper: Tran TXM, Jung SY, Lee EG, Cho H (Heeyoun Cho), Kim NY, Shim S, Kim HY, Kang D, Cho J, Lee E, Chang YJ, Cho H (Hyunsoon Cho).
Conflicts of Interest
Conflict of interest relevant to this article was not reported.
Characteristic | Total (n=333) | By FCR status | ||
---|---|---|---|---|
No (n=180, 54%) | Yes (n=153, 46%) | p-value | ||
Sociodemographic | ||||
Age at diagnosis (yr) | ||||
Mean±SD | 45.5±8.1 | 47.3±8.0 | 43.5±0.7 | < 0.001a) |
≤ 45 | 166 (49.9) | 70 (38.9) | 96 (62.8) | < 0.001b) |
> 45 | 167 (50.1) | 110 (61.1) | 57 (37.2) | |
Age at survey (yr) | ||||
Mean±SD | 57.2±8.4 | 59.1±8.3 | 54.9±7.9 | < 0.001a) |
≤ 65 | 282 (84.7) | 144 (80.0) | 138 (90.2) | 0.010b) |
> 65 | 51 (15.3) | 36 (20.0) | 15 (9.8) | |
Household income | ||||
< 3 mil KRW | 135 (40.8) | 70 (39.3) | 65 (42.5) | 0.632b) |
3 mil to < 5 mil KRW | 95 (28.7) | 55 (30.9) | 40 (26.1) | |
≥ 5 mil KRW | 101 (30.5) | 53 (29.8) | 48 (31.4) | |
Employment status | ||||
Housewife/Unemployed | 158 (47.4) | 86 (47.8) | 72 (47.1) | 0.896b) |
Employed | 175 (52.6) | 94 (52.2) | 81 (52.9) | |
Education level | ||||
High school graduate or lower | 196 (59.0) | 109 (60.9) | 87 (56.9) | 0.457b) |
University graduate or higher | 136 (41.0) | 70 (39.1) | 66 (43.1) | |
Marital status | ||||
Married and living with a spouse | 243 (72.9) | 136 (75.6) | 107 (69.9) | 0.250b) |
Other | 90 (27.1) | 44 (24.4) | 46 (30.1) | |
Obesity status: yes | 67 (20.1) | 35 (19.4) | 32 (20.9) | 0.739b) |
Comorbidity status: yes | 79 (23.8) | 49 (27.2) | 30 (19.7) | 0.111b) |
Menopausal status: yes | 281 (84.4) | 160 (88.9) | 121 (79.1) | 0.014b) |
Pregnancy history: yes | 301 (90.9) | 164 (91.1) | 137 (90.7) | 0.904b) |
Clinical | ||||
Time since diagnosis (yr) | ||||
≤ 10 | 209 (62.8) | 104 (57.8) | 105 (68.6) | 0.041b) |
> 10 | 124 (37.2) | 76 (42.2) | 48 (31.4) | |
Stage at diagnosis | ||||
Stage 0, I, II | 300 (90.1) | 164 (91.1) | 136 (88.9) | 0.499b) |
Stage III, IV | 33 (9.9) | 16 (8.9) | 17 (11.1) | |
Recurrence: yes | 32 (9.6) | 11 (6.1) | 21 (13.7) | 0.019b) |
Surgery: lumpectomy | 286 (85.9) | 155 (86.1) | 131 (85.6) | 0.898b) |
Chemotherapy: yes | 239 (72.2) | 124 (69.3) | 115 (75.7) | 0.196b) |
Radiotherapy: yes | 287 (86.7) | 154 (86.0) | 133 (87.5) | 0.695b) |
Hormone therapy: yes | 268 (80.9) | 143 (79.9) | 125 (82.2) | 0.588b) |
BC molecular subtype | ||||
Luminal A | 238 (71.9) | 129 (72.5) | 109 (71.2) | 0.522b) |
Luminal B | 31 (9.3) | 14 (7.9) | 17 (11.1) | |
HER2 positive | 23 (6.9) | 15 (8.4) | 8 (5.2) | |
Triple-negative | 39 (11.8) | 20 (11.2) | 19 (12.4) | |
Histological subtypes: IDC | 291 (92.4) | 157 (93.5) | 134 (91.2) | 0.444b) |
Factor | FCR | ||
---|---|---|---|
aORa) | 95% CI | p-value | |
Age at diagnosis (yr) | |||
> 45 | 1.00 | ||
≤ 45 | 2.64 | 1.51–4.60 | 0.001 |
Age at survey (yr) | |||
> 65 | 1.00 | ||
≤ 65 | 1.11 | 0.53–2.33 | 0.775 |
Menopausal status | |||
Yes | 1.00 | ||
No | 1.20 | 0.60–2.39 | 0.613 |
Time since diagnosis (yr) | |||
> 10 | 1.00 | ||
≤ 10 | 1.75 | 1.08–2.89 | 0.028 |
Stage at diagnosis | |||
Stage 0, I, II | 1.00 | ||
Stage III, IV | 1.17 | 0.55–2.49 | 0.785 |
Recurrence | |||
No | 1.00 | ||
Yes | 2.56 | 1.16–5.65 | 0.020 |
Sociodemographic and clinical characteristics of the study population (n=333)
Characteristic | Total (n=333) | By FCR status | ||
---|---|---|---|---|
No (n=180, 54%) | Yes (n=153, 46%) | p-value | ||
Sociodemographic | ||||
Age at diagnosis (yr) | ||||
Mean±SD | 45.5±8.1 | 47.3±8.0 | 43.5±0.7 | < 0.001 |
≤ 45 | 166 (49.9) | 70 (38.9) | 96 (62.8) | < 0.001 |
> 45 | 167 (50.1) | 110 (61.1) | 57 (37.2) | |
Age at survey (yr) | ||||
Mean±SD | 57.2±8.4 | 59.1±8.3 | 54.9±7.9 | < 0.001 |
≤ 65 | 282 (84.7) | 144 (80.0) | 138 (90.2) | 0.010 |
> 65 | 51 (15.3) | 36 (20.0) | 15 (9.8) | |
Household income | ||||
< 3 mil KRW | 135 (40.8) | 70 (39.3) | 65 (42.5) | 0.632 |
3 mil to < 5 mil KRW | 95 (28.7) | 55 (30.9) | 40 (26.1) | |
≥ 5 mil KRW | 101 (30.5) | 53 (29.8) | 48 (31.4) | |
Employment status | ||||
Housewife/Unemployed | 158 (47.4) | 86 (47.8) | 72 (47.1) | 0.896 |
Employed | 175 (52.6) | 94 (52.2) | 81 (52.9) | |
Education level | ||||
High school graduate or lower | 196 (59.0) | 109 (60.9) | 87 (56.9) | 0.457 |
University graduate or higher | 136 (41.0) | 70 (39.1) | 66 (43.1) | |
Marital status | ||||
Married and living with a spouse | 243 (72.9) | 136 (75.6) | 107 (69.9) | 0.250 |
Other | 90 (27.1) | 44 (24.4) | 46 (30.1) | |
Obesity status: yes | 67 (20.1) | 35 (19.4) | 32 (20.9) | 0.739 |
Comorbidity status: yes | 79 (23.8) | 49 (27.2) | 30 (19.7) | 0.111 |
Menopausal status: yes | 281 (84.4) | 160 (88.9) | 121 (79.1) | 0.014 |
Pregnancy history: yes | 301 (90.9) | 164 (91.1) | 137 (90.7) | 0.904 |
Clinical | ||||
Time since diagnosis (yr) | ||||
≤ 10 | 209 (62.8) | 104 (57.8) | 105 (68.6) | 0.041 |
> 10 | 124 (37.2) | 76 (42.2) | 48 (31.4) | |
Stage at diagnosis | ||||
Stage 0, I, II | 300 (90.1) | 164 (91.1) | 136 (88.9) | 0.499 |
Stage III, IV | 33 (9.9) | 16 (8.9) | 17 (11.1) | |
Recurrence: yes | 32 (9.6) | 11 (6.1) | 21 (13.7) | 0.019 |
Surgery: lumpectomy | 286 (85.9) | 155 (86.1) | 131 (85.6) | 0.898 |
Chemotherapy: yes | 239 (72.2) | 124 (69.3) | 115 (75.7) | 0.196 |
Radiotherapy: yes | 287 (86.7) | 154 (86.0) | 133 (87.5) | 0.695 |
Hormone therapy: yes | 268 (80.9) | 143 (79.9) | 125 (82.2) | 0.588 |
BC molecular subtype | ||||
Luminal A | 238 (71.9) | 129 (72.5) | 109 (71.2) | 0.522 |
Luminal B | 31 (9.3) | 14 (7.9) | 17 (11.1) | |
HER2 positive | 23 (6.9) | 15 (8.4) | 8 (5.2) | |
Triple-negative | 39 (11.8) | 20 (11.2) | 19 (12.4) | |
Histological subtypes: IDC | 291 (92.4) | 157 (93.5) | 134 (91.2) | 0.444 |
Values are presented as number (%) unless otherwise indicated. BC, breast cancer; FCR, fear of cancer recurrence; HER2, human epidermal growth factor receptor 2; IDC, invasive ductal carcinoma; KRW, Korean Won; SD, standard deviation.
a)p-value obtained from the t test,
b)Chi-square test.
HRQoL and depression score by FCR status (n=333)
HRQoL and depression | Range | Mean±SD | Difference | p-value | |
---|---|---|---|---|---|
FCR: No (n=180) | FCR: Yes (n=153) | ||||
EQ-5D index | 0–1 | 0.945±0.074 | 0.887±0.088 | 0.057 | < 0.001 |
PHQ-9: total depression score | 0–27 | 1.4±2.1 | 4.1±4.5 | 2.8 | < 0.001 |
EORTC QLQ-C30 functions | |||||
Physical Functioning | 0–100 | 89.2±9.2 | 83.6±13.9 | 5.6 | < 0.001 |
Role Functioning | 0–100 | 91.8±14.0 | 81.7±23.2 | 10.1 | < 0.001 |
Emotional Functioning | 0–100 | 86.7±15.0 | 72.3±20.9 | 14.4 | < 0.001 |
Cognitive Functioning | 0–100 | 82.9±16.3 | 75.1±17.7 | 7.8 | < 0.001 |
Social Functioning | 0–100 | 93.0±14.0 | 82.7±22.3 | 10.3 | < 0.001 |
EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30; EQ-5D, EuroQoL; FCR, fear of cancer recurrence; HRQoL, health-related quality of life; PHQ-9, Patient Health Questionnaire-9; SD, standard deviation.
Multivariate logistic regression on factors associated with FCR (n=333)
Factor | FCR | ||
---|---|---|---|
aOR |
95% CI | p-value | |
Age at diagnosis (yr) | |||
> 45 | 1.00 | ||
≤ 45 | 2.64 | 1.51–4.60 | 0.001 |
Age at survey (yr) | |||
> 65 | 1.00 | ||
≤ 65 | 1.11 | 0.53–2.33 | 0.775 |
Menopausal status | |||
Yes | 1.00 | ||
No | 1.20 | 0.60–2.39 | 0.613 |
Time since diagnosis (yr) | |||
> 10 | 1.00 | ||
≤ 10 | 1.75 | 1.08–2.89 | 0.028 |
Stage at diagnosis | |||
Stage 0, I, II | 1.00 | ||
Stage III, IV | 1.17 | 0.55–2.49 | 0.785 |
Recurrence | |||
No | 1.00 | ||
Yes | 2.56 | 1.16–5.65 | 0.020 |
aOR, adjusted odds ratio; CI, confidence interval; FCR, fear of cancer recurrence.
a)Adjusted for age at survey, menopausal status, age at diagnosis, time since diagnosis, stage at diagnosis, and recurrence history.
Values are presented as number (%) unless otherwise indicated. BC, breast cancer; FCR, fear of cancer recurrence; HER2, human epidermal growth factor receptor 2; IDC, invasive ductal carcinoma; KRW, Korean Won; SD, standard deviation. p-value obtained from the t test, Chi-square test.
EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30; EQ-5D, EuroQoL; FCR, fear of cancer recurrence; HRQoL, health-related quality of life; PHQ-9, Patient Health Questionnaire-9; SD, standard deviation.
aOR, adjusted odds ratio; CI, confidence interval; FCR, fear of cancer recurrence. Adjusted for age at survey, menopausal status, age at diagnosis, time since diagnosis, stage at diagnosis, and recurrence history.