Qudity ofLifi Research, 2, pp. 13-22 Women with lung cancer: impact on quality of life L. Sarna School of Nusing, University of California at Los Angeles, 10833 Le Conte, Los Angeles, CA 90024-6918, USA. Tel: + 1 310 8258690, Fax: + 1 310 206 7433. The purpose of this study was to describe disruptions in quality of life (QOL) in women suffering from lung cancer, the leading cause of cancer-related death in the United States. QOL was measured with the CARES-SF. Symptom distress was measured with the modified Symptom Distress Scale, and functional status was measured with the Karnofsky Performance Status Scale. Sixty-nine women with lung cancer participated in a one-time data collection. The typical subject was under 65 years of age, married, has had primary or recurrent non-small cell lung cancer for over 12 months, had limited disease, and was not currently receiving treatment. Subjects had greater disruptions in global QOL and its dimensions com- pared to a normative heterogeneous female cancer sample. The most prevalent serious disruptions were fatigue, difficulty with household chores, worry about ability to care for self, and worry about cancer progression. The global CARES-SF score was moder- ately correlated to functional status (r = 0.69, P = <O.OOl), and to symptom distress (f = 0.72, P = <O.OOl). Symptom distress was associated strongly with the physical subscale of QOL (r = O-80, P = 0.001) and significantly but less strongly with all other dimensions of QOL. Significantly greater differ- ences in disruptions of quality of life occurred in women younger than 65 years (P = 0.04), women with recurrent disease (p = 0.003), and women with low income (p = 0.008) In stepwise regression, symptom distress predicted 53% of the variance followed by functional status (59%) and recurrence (63%) when QOL was the outcome variable. Key words: CARES-SF, Functional status, Karnofsky Performance Status, lung cancer, women, quality of life, Sympton Distress Scale 66,000 new cases of lung cancer diagnosed among women in the US in 1992, and an estimated 53,000 lung cancer deaths among women.3 Lung cancer accounts for 12% of all cancers for women in the US and 22% of female cancer-related deaths.’ Age-specific lung cancer mortality rates for women increased by 33% between 1973-74 and 1986-87, to a current 22.7 deaths/lOO,OOO women/year. This can be compared to an 11% decline in men.5 Deaths from lung cancer in women are an inter- national problem as well, with the highest age- adjusted death rates in Scotland (27.1), Hong Kong (25.0), Ireland (23.1), Denmark (22.3) and England and Wales (20.0).3 Quality of life measures have emerged not only as important adjuncts to clinical measures of treatment response and disease progression, par- ticularly for those with lung cancer, but as tools to identify needs for care. ’ Since most patients with lung cancer are treated with palliative intent, more data are needed about the experience of living with lung cancer to guide health care providers in assessment, problem identification and interven- tion during the chronic illness trajectory. Research directed at describing the experience of living with lung cancer is difficult, and problems with access and attrition have been reported.7,6 Despite the prevalence of lung cancer among women, no known study has been devoted to describing the female experience. Introduction Background Almost a decade ago, lung cancer overtook breast cancer as the leading cause of cancer-related deaths in females. lt2 There were an estimated Although lung cancer is a major health problem, relatively few studies have documented the dis- ruptions in quality of life beyond performance status in adults with lung cancer.9-13 Those that do exist include very few women, and data are rarely reported separately by sex. The female experience of lung cancer may be uniquely affected by demands of the family and the subsequent burden Supported in part by Gamma Tau: Sigma Theta Tau, Academic Senate, University of California, Los Angeles, the UCLA School of Nursing, and the American Cancer Societv, California Division - ,. 0 2993 Rapid Communicutions of Oxford Ltd Quality of L+ Research . Vol2 . 2993 I.3