Surviving Or Thriving? An Assessment of Patient-Reported Quality of Life Among Breast Cancer and Lymphoma Survivors in Malawi
Stephen Kimani, John Chapola, Dalton Craven, Katherine Westmoreland, Matthew Painschab, Agatha Bula, Katherine Reeder-Hayes, Satish GopalPURPOSE
Improvements in cancer care have increased survival and the population of cancer survivors in sub-Saharan Africa (SSA), yet data on patient-reported outcomes, including health-related quality of life (HRQoL), remain scarce. We assessed HRQoL among breast cancer and lymphoma survivors at Kamuzu Central Hospital, Malawi.
METHODS
Between June 2023 and April 2024, we recruited survivors at Kamuzu Central Hospital in Lilongwe, Malawi, aged ≥18 years with breast cancer (n = 27) or lymphoma (n = 27), who had completed curative-intent treatment via existing observational cohort studies and were in remission on follow-up. Participants completed the PROMIS® 29+2 Profile (v2.1, PROPr) via audio-computer-assisted self-interview. We compared mean PROMIS T-scores to published US references estimates of cancer survivors using T test.
RESULTS
Cancer survivors were female (67%), younger than 50 years (56%; median age = 48), had completed primary school or further education (51.8%), and had good performance status (ECOG <2 in 80%). All HIV-positive survivors (43%) were on antiretroviral therapy. Compared to survivors in the US, cancer survivors in Malawi experienced less fatigue, less pain interference, better sleep quality, and better physical and social functioning (
CONCLUSION
Breast cancer and lymphoma survivors in Malawi showed better mental health, physical, and social functioning HRQoL compared to US survivors. Age group and cancer type differences warrant further study. Targeted survivorship interventions addressing pain are needed in Malawi.