Differences in quality of life between American and Chinese breast cancer survivors

Qian Lu, Jin You, April Kavanagh, Krystal Warmoth, Zhiqiang Meng, Zhen Chen, Kavita D Chandwani, George H Perkins, Jennifer Leigh McQuade, Nelamangala V Raghuram, Raghuram Nagarathna, Zhongxing Liao, Hongasandra Ramarao Nagendra, Jiayi Chen, Xiaoma Guo, Luming Liu, Banu Arun, Lorenzo Cohen

    Research output: Contribution to journalArticlepeer-review

    6 Citations (Scopus)


    OBJECTIVE: It has been speculated that cancer survivors in Asia may have lower quality of life (QOL) compared with their Western counterparts. However, no studies have made international comparisons in QOL using a comprehensive measure. This study aimed to compare Chinese breast cancer survivors' QOL with US counterparts and examine if demographic and medical factors were associated with QOL across groups.

    METHOD: The sample consisted of 159 breast cancer patients (97 Chinese and 62 American) who completed the Functional Assessment for Cancer Therapy Breast Cancer (FACT-B) scale before the start of radiotherapy in Shanghai, China and Houston, USA.

    RESULTS: Higher income was associated with higher QOL total scores in both Chinese and American cancer patients, but QOL was not significantly associated with other factors including age, education, disease stage, mastectomy, and chemotherapy. Consistent with hypotheses, compared to their US counterparts, Chinese breast cancer survivors reported lower QOL and all four subdimensions including functional well-being (FWB), physical well-being (PWB), emotional well-being (EWB), and social well-being (SWB); they also reported more breast cancer-specific concerns (BCS). Differences were also clinically significant for Functional Assessment for Cancer Therapy General (FACT-G) scale total scores and the FWB subscale. After controlling for demographic and medical covariates, these differences remained except for the SWB and BCS. Furthermore, Chinese breast cancer survivors receiving chemotherapy reported significantly lower FACT-G scores than those who did not, but this difference did not emerge among US breast cancer survivors.

    DISCUSSION: Chinese breast cancer survivors reported poorer QOL on multiple domains compared to US women. Findings indicate that better strategies are needed to help improve the QOL of Chinese breast cancer survivors, especially those who underwent chemotherapy.

    Original languageEnglish
    Pages (from-to)3775-82
    Number of pages8
    JournalSupportive Care in Cancer
    Issue number9
    Early online date6 Apr 2016
    Publication statusPublished - Sept 2016


    • Adult
    • Aged
    • Breast Neoplasms/mortality
    • China
    • Female
    • Humans
    • Middle Aged
    • Quality of Life/psychology
    • Survivors
    • United States


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