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dc.contributor.authorKillie, Ida Løken
dc.contributor.authorBraaten, Tonje
dc.contributor.authorLorem, Geir F
dc.contributor.authorBorch, Kristin Benjaminsen
dc.date.accessioned2025-08-18T06:57:56Z
dc.date.available2025-08-18T06:57:56Z
dc.date.issued2025-08-13
dc.description.abstractObjectives - Self-rated health (SRH) is a well-established predictor of all-cause mortality. However, its predictive value in patients with cancer remains unclear. We aimed to elucidate the relationship between prediagnostic SRH and mortality among patients with cancer using data from the Norwegian Women and Health (NOWAC) Study.<p> <p>Design - A prospective cohort study.<p> <p>Settings and participants - This study included 26 405 women from the NOWAC cohort who were diagnosed with cancer between 1992 and 2020. Subgroup analyses focused on the most common cancer types among Norwegian women: breast (n=8299), colorectal (n=3653) and lung and bronchial (n=2428) cancers.<p> <p>Primary and secondary outcome measures - Prediagnostic SRH was assessed using a single-item measure with four response alternatives and categorised into ‘very good’, ‘good’ and ‘poor’ SRH. We used flexible parametric survival analysis and competing risk regression models to evaluate the association between SRH and all-cause and cancer-specific mortality after adjusting for age, physical activity, Body Mass Index, smoking, alcohol consumption and education.<p> <p>Results - Poor prediagnostic SRH was associated with increased all-cause mortality among long-term cancer survivors. For specific cancer sites, the adjusted HRs and 95% CI for poor versus very good SRH were 1.29 (95% CI: 1.06 to 1.58) for breast cancer and 1.50 (95% CI: 1.20 to 1.88) for colorectal cancer. These associations were more pronounced among long-term survivors than short-term survivors. No association was observed between prediagnostic SRH and mortality for patients with lung cancer. For cancer-specific mortality, prediagnostic SRH predicted mortality from all cancers, as well as from colorectal cancer.<p> <p>Conclusions - Prediagnostic SRH is a significant predictor of mortality in patients with cancer, particularly among long-term survivors. These findings indicate the potential of SRH as a predictive tool for mortality, underscoring the importance of integrating SRH assessments into identifying individuals at higher risk of mortality and highlighting the potential benefits of public health interventions aimed at improving overall health, but further studies are required to assess the effect of such interventions on SRH.en_US
dc.identifier.citationKillie, Braaten, Lorem, Borch. Prediagnostic self-rated health and survival in women diagnosed with cancer in the Norwegian Women and Health Study: a prospective cohort study. BMJ Open. 2025
dc.identifier.cristinIDFRIDAID 2397497
dc.identifier.doi10.1136/bmjopen-2025-099992
dc.identifier.issn2044-6055
dc.identifier.urihttps://hdl.handle.net/10037/37994
dc.language.isoengen_US
dc.publisherBMJ Publishing Groupen_US
dc.relation.journalBMJ Open
dc.relation.projectIDNorges forskningsråd: 289440
dc.rights.holderCopyright 2025 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0en_US
dc.rightsAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)en_US
dc.titlePrediagnostic self-rated health and survival in women diagnosed with cancer in the Norwegian Women and Health Study: a prospective cohort studyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
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