Influence of age, body mass index and family income on the health Quality of Life among the breast cancer patients in Bangladesh: a cross-sectional study

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Background: This study aimed to investigate the influence of BMI, age, and socioeconomic status on QoL among BC patients in Bangladesh. Methods: This cross-sectional study was conducted among 200 female breast cancer patients who had completed treatment or were undergoing follow-up at the Shanti Oncology and Palliative Care Foundation, Dhaka, Bangladesh, between May 2023 and July 2024. Participants were interviewed using validated European Organization for Research and Treatment of Cancer (EORTC) questionnaires. The QLQ-C30 for general cancer-related QoL and the BR23 module specific for breast cancer. Key independent variables included variables age, family income and BMI, assessed in relation to cancer profile, global health scores, C30-BR23 functional domains, and symptom scales. Data analysis involved descriptive statistics, assessment of normality using the Shapiro-Wilk test, and inferential analyses using logistic and linear regression models to evaluate associations between independent variables with cancer profile and QoL scale. Results: Among 200 breast cancer patients, the mean age was 49.5 years (SD 9.02), with the majority overweight (52.5%) and housewives (74%). Most had Stage II (53%) cancer, 58.5% underwent mastectomy, and 98% received chemotherapy. Global health score (GHS) was 42.44 (SD 12.46). Regression analyses identified age and family income as the most significant factors associated with QoL in this study. Older age was significantly associated with lower GHS score (β = -4.68; 95% CI: -6.68 to -2.67; p < 0.001), as well as higher insomnia (β = 6.45; 95% CI: 0.45 to 12.46; p = 0.035) and dyspnea (β = 5.64; 95% CI: 0.45 to 10.84; p = 0.033) scores. Higher family income was significantly associated with localization of BC (AOR = 1.51, 95% CI: 1.02-2.23, p = 0.038), metastasis (AOR = 2.03, 95% CI: 1.28-3.22, p = 0.003), undergoing mastectomy (AOR = 1.55, 95% CI: 1.07-2.25, p = 0.020), and receiving radiotherapy (AOR = 11.92, 95% CI: 2.34-60.63, p = 0.003). Lower family income was significantly associated with increased financial difficulties (β = -11.88; 95% CI: -16.76 to -7.00; p < 0.001), poorer future perspectives (β = -5.66; 95% CI: -10.15 to -1.16; p = 0.014), and worse breast and systemic therapy side effects (β = -5.44; 95% CI: -8.94 to -1.94; p = 0.002; β = 4.07; 95% CI: 1.23 to 6.90; p = 0.005, respectively). BMI indicated limited associations, which include increased dyspnea (β = 1.40; 95% CI: 0.15 to 2.64; p = 0.028) and decreased diarrhea scores (β = -2.11; 95% CI: -3.09 to -1.13; p < 0.001). Conclusion: The overall QoL score was poor among Bangladeshi patients. The association of BMI with C30 and BR23 was limited. In this study, age and family income were statistically significant predictors of QoL. Further studies with larger sample sizes are recommended to better explore the association between higher BMI and QoL among BR patients.

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