Physical and mental health status of older long-term cancer survivors

OBJECTIVES: To assess the physical and mental health status of older long-term cancer survivors. DESIGN: Cohort study using propensity score methods to control for baseline differences between cancer survivors and controls. SETTING: General community population in the United States. PARTICIPANTS: Nine hundred sixty-four cancer patients who had survived for more than 4 years and 14,333 control patients who had never had cancer from a population-based sample of Americans aged 55 and older responding to the 2002 Health and Retirement Study. MEASUREMENTS: Medical conditions, symptoms, health behaviors, health status, mobility, activities of daily living, mental health diagnoses, self-rated memory, depressive symptoms, cognitive function, and self-reported life expectancy. RESULTS: Cancer survivors reported higher rates of lung disease (13.9% vs 9.6%; P = .001), heart condition (29.3% vs 22.9%; P < .001), arthritis (69.4% vs 59.4%; P < .001), incontinence (26.6% vs 19.7%; P = .001), frequent pain (36.4% vs 29.4%; P = .005), and obesity (27.0% vs 24.2%; P = .001) than individuals without cancer but lower rates of smoking (12.0% vs 14.8%; P = .03). Cancer survivors were less likely than persons without cancer to report excellent or very good health status (37.2% vs 44.6%; P < .001) and had more mobility (P < .001) and activity of daily living (P = .01) limitations. Cancer survivors did not differ from persons without cancer in rates of depression or cognitive function (both P > .2) but were less optimistic about their life expectancy (P = .004). CONCLUSION: The physical health status of older long-term cancer survivors is somewhat worse than that of comparable persons who have never had cancer, but they have surprisingly similar mental health status. Future research is needed to understand factors contributing to poorer health status and identify patients at highest risk of long-term cancer-related problems.