Functional status declines among cancer survivors: Trajectory and contributing factors

Jessica L. Petrick, Bryce B. Reeve, Anna M. Kucharska-Newton, Randi E. Foraker, Elizabeth A. Platz, Sally C. Stearns, Xuesong Han, B. Gwen Windham, Debra E. Irwin

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Objective: This study aimed to quantify functional status (FS) trajectories pre- and post-diagnosis of cancer, FS trajectories among cancer-free individuals, and factors affecting FS. Materials and Methods: Self-reported FS, scored from 0 (worst) to 100 (best), of Atherosclerosis Risk in Communities (ARIC) Study cohort participants diagnosed with incident cancer (lung (N= 303), breast (N= 374), prostate (N= 529), colorectal (N= 228)), and cancer-free participants (N= 11,155) over 15. years was examined. FS was evaluated in two ways: 1) until death or follow-up year 15 (Model 1) and 2) same as survivorship model except that a FS value of zero was used for assessments after death to follow-up year 15 (Model 2). Mean FS at discrete time points were used to generate FS trajectories. Differences in repeated measures of FS were assessed using linear growth models. Results: Within one year after diagnosis, FS scores declined compared to the cancer-free group, except for prostate cancer. FS continued to decline beyond one year after lung or colorectal cancer diagnosis. FS was lower in all cancer groups, except prostate, compared to the cancer-free group (Model 1: lung - 4.76, breast - 2.28, colorectal - 2.55; Model 2: lung - 2.36, breast - 2.46, colorectal - 2.31). Predictors of decreased FS score independent of cancer diagnosis included low education, comorbidities, obesity, smoking, lack of health insurance, and age. Conclusion: FS in all incident cancer groups declined during the first year post-diagnosis, which could be due to intensive treatments. Targeting factors related to FS declines could improve health outcomes for patients with cancer.

Original languageEnglish
Pages (from-to)359-367
Number of pages9
JournalJournal of Geriatric Oncology
Issue number4
StatePublished - Oct 1 2014

Bibliographical note

Funding Information:
The authors thank the staff and participants of the ARIC study for their important contributions. Cancer incidence data have been provided by the Maryland Cancer Registry, Center for Cancer Surveillance and Control, Department of Mental Health and Hygiene, 201 W. Preston Street, Room 400, Baltimore, MD 21201. We acknowledge the State of Maryland, the Maryland Cigarette Restitution Fund, and the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC) for the funds that helped support the availability of the cancer registry data.

Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by the National Heart, Lung, and Blood Institute contracts ( HHSN268201100005C , HHSN268201100006C , HHSN268201100007C , HHSN268201100008C , HHSN268201100009C , HHSN268201100010C , HHSN268201100011C , and HHSN268201100012C ). Studies on cancer in ARIC are also supported by the National Cancer Institute ( U01 CA164975-01 ). The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2014 Elsevier Inc.


  • Cancer survivorship
  • Functional status
  • Health-related quality of life
  • Longitudinal studies

ASJC Scopus subject areas

  • Oncology
  • Geriatrics and Gerontology


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