Understanding the Diverse Experiences of Cancer Survivors: Implications for Personalised Care from a Latent Profile Analysis of HRQoL

Background and objective: Cancer and its treatments can impact on HrQOL in several ways. Symptom burden both during and after treatment can be quite large in cancer patients, impacting HrQOL. In addition, changes in muscle mass can impair physical functioning with other aspects of functioning also impacted by the cancer and its treatment. Even after treatment, physical and cognitive impairment, anxiety and fear of cancer recurrence can persist. In clinical practice understanding how aspects of HrQOL group together may allow clinicians to better understand and treat cancer survivors. The aim of this research was to examine heterogeneity of HrQOL in Irish Cancer Survivors (both undergoing and completed treatment) using latent profile analysis. A secondary aim was to determine whether these groups differed by select demographic and health characteristics. Methods: Participants were recruited through the oncology day ward and outpatient department in one Irish Hospital between September 2019 and March 2020. Anthropometric measures were taken and patients completed a series of questionnaires including the EORTC-QLQ-C30 to determine health related quality of life. Latent profile analysis was undertaken using mPlus. Results: Three distinct profiles were observed: high quality of life (52.5%); compromised quality of life (34.2%) and low quality of life (13%). All groups scored lower for functioning scales (with the exception of the high quality of life group for physical, role and emotional functioning) and higher for symptom scales then the reference norm population. There were large clinically meaningful differences between the high quality of life and low quality of life groups for all scales. the odds of belonging to the (compromised quality of life group decreased significantly by having higher handgrip strength (OR = .955, p < .05, CI = .924 - .988). Those who were working were over 7 times more likely to be in the low quality of life group than the referent class (high quality of life group). The odds of belonging to the low quality of life group increased significantly for those with higher number of nutrition impact symptoms (NIS) (OR = 1.375, p < .05, CI = 1.004 – 1.883). Conclusion: an empirically driven patient-centred LPA approach characterised Heath related Quality of Life in Irish Cancer Survivors into three distinct patient groups. This allows for more targeted, effective interventions, enhances the ability to design personalised treatment plans and could optimise resource allocation in healthcare settings.