METHODS: We conducted a cross-sectional analysis of the 2020 Behavioral Risk Factor Surveillance System from states that administered ACEs and Cancer Survivorship modules. Eligibility criteria included being a cancer survivor and not currently receiving cancer treatment. Primary exposure was number of ACEs (categorized as 0, 1-2, 3, or ≥ 4). Primary outcomes were self-reported measures of HRQOL including worse overall health and ≥ 14 unhealthy days (mentally or physically) per month. Mantel-Haenszel stratified analyses were performed and prevalence ratios were adjusted for age.
RESULTS: Of 5,780 participants, 62.0% were female and 67.8% were ≥ 65 years. Prevalence of worse overall health was 22.5% for individuals with no ACEs compared to 30.2% for 2-3 ACEs (aPR = 1.4, 95% CI 1.2, 1.5) and 38.5% for ≥ 4 ACEs (aPR = 1.7, 95% CI 1.5, 2.0). Prevalence of ≥ 14 unhealthy days was 18.1% with no ACEs compared to 21.0% for 1 ACE (aPR = 1.3, 95% CI 1, 1.3), 29.0% for 2-3 ACEs (aPR = 1.6, 95% CI 1.4, 1.8), and 44.8% for ≥ 4 ACEs (aPR = 2.2, 95% CI 2.0, 2.5).
CONCLUSIONS: Our study provides novel evidence of the association of multiple ACEs with higher prevalence of poor HRQOL in cancer survivors.
CONCLUSIONS: Screening for ACEs is warranted in all patients to guide targeted interventions to improve HRQOL and mitigate the impact of ACEs on HRQoL in cancer survivors.
方法:我们从管理ACE和癌症生存模块的州对2020年行为危险因素监测系统进行了横断面分析。资格标准包括是癌症幸存者并且目前未接受癌症治疗。主要暴露是ACEs的数量(分类为0、1-2、3或≥4)。主要结果是自我报告的HRQOL指标,包括总体健康状况较差和每月≥14天(精神或身体)不健康。进行Mantel-Haenszel分层分析,并根据年龄调整患病率。
结果:在5,780名参与者中,62.0%为女性,67.8%为≥65岁。没有ACE的个体总体健康状况较差的患病率为22.5%,而2-3个ACE的患病率为30.2%(aPR=1.4,95%CI1.2,1.5),≥4个ACE的患病率为38.5%(aPR=1.7,95%CI1.5,2.0)。≥14天不健康的患病率为18.1%,没有ACE,而1ACE为21.0%(aPR=1.3,95%CI1,1.3),2-3种ACEs为29.0%(APR=1.6,95%CI1.4,1.8),≥4种ACEs的比例为44.8%(aPR=2.2,95%CI2.0,2.5)。
结论:我们的研究提供了癌症幸存者中多种ACE与较高的低HRQOL患病率相关的新证据。
结论:所有患者都有必要进行ACE筛查,以指导针对性干预措施改善HRQOL并减轻ACE对癌症幸存者HRQoL的影响。