Introduction:
Cigarette smoking is a known risk factor for bladder cancer and multiple studies have characterized the impact of smoking on health-related quality of life (HRQoL) in the general population. However, there is a paucity of data characterizing the relationship between smoking status and longitudinal HRQoL outcomes in bladder cancer patients, despite the known association between risk factor and disease. We sought to examine the association between current smoking status and HRQoL measures among bladder cancer patients following their cancer diagnosis.
Methods:
We performed a longitudinal, prospective study on patients aged ≥18 years diagnosed with bladder cancer across North Carolina from 2014-2015. Both muscle invasive and non-muscle invasive patients were included. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core instrument (QLQ-C30), which measures multiple quality of life domains, was administered at baseline, 3, 12, and 24 months after initial bladder cancer diagnosis. This questionnaire has been validated in diverse samples of cancer patients and provides a comprehensive assessment of patients' difficulties. The main exposure variable was current smoking status, which was assessed at baseline, 3, 12, and 24 months after bladder cancer diagnosis. We then applied linear regression using Generalized Estimating Equations (GEE) to analyze mean differences for each outcome between exposure groups.
Results:
A total of 167 patients were recruited for analysis, of which 154 met inclusion criteria and completed at least one survey. Cohort demography are shown in Table 1. Of those, a total of 125 patients who did not smoke completed surveys at 3, 108 at 12, and 86 at 24 months. A total of 28 patients who smoked completed surveys at 3, 23 at 12, and 25 at 24 months. Bladder cancer patients who smoked had significantly worse HRQoL measures in the domains of physical function (mean difference (MD) = 6.78, p < .05), emotional function (MD = 6.06, p < .05), fatigue measures (MD = -7.68, p < .05), and financial difficulties (MD = -10.20, p < .05). When controlling for time from diagnosis, covariates, and treatment, physical function (MD = 7.3), emotional function (MD = 5.4), and fatigue measures (MD = -7.32) remained significantly different (Table 2).
Conclusion:
Bladder cancer patients who smoke have significantly worse HRQoL scores in the domains of physical function, emotional wellbeing, and fatigue. These results further underscore the need to treat smoking as an essential component of bladder cancer care. Future work should implement smoking interventions that are directed at patient goals with respect to their unique values regarding life quality, and with an emphasis on the longitudinal impacts of smoking on quality of life.
Funding: N/A
Image(s) (click to enlarge):
IMPACT OF SMOKING ON LONGITUDINAL HEALTH RELATED QUALITY OF LIFE MEASURES AMONG BLADDER CANCER SURVIVORS
Category
Bladder Cancer > Other
Description
Poster #45
Wednesday, November 30
4:00 p.m. - 5:00 p.m.
Presented By: Hannah Elizabeth Kay
Authors:
Hannah E. Kay, MD
Sarah Silver
Richard S. Matulewicz, MD, MS
Kimberly Shoenbill, MD, PhD
Ramsankar Basak, PhD
Marc A. Bjurlin, DO, MSc