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Urban-rural variations in quality-of-life in breast cancer survivors prescribed endocrine therapy

Lookup NU author(s): Dr Stephan Dombrowski, Professor Linda Sharp



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2017 by the authors. Licensee MDPI, Basel, Switzerland. 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 (β = 3.81, standard error (SE) 1.30, p < 0.01), emotional QoL (β = 0.70, SE 0.21, p < 0.01) and experienced a lower symptom burden (β = 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.

Publication metadata

Author(s): Cahir C, Thomas AA, Dombrowski SU, Bennett K, Sharp L

Publication type: Article

Publication status: Published

Journal: International Journal of Environmental Research and Public Health

Year: 2017

Volume: 14

Issue: 4

Online publication date: 07/04/2017

Acceptance date: 05/04/2017

Date deposited: 25/04/2017

ISSN (print): 1661-7827

ISSN (electronic): 1660-4601

Publisher: MDPI AG


DOI: 10.3390/ijerph14040394


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