ArticleBMC women's health2026
Health-related quality of life among working-age women with breast cancer in Croatia: a population-referenced cross-sectional study.
Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHealth-related quality of life (HRQoL) is a key outcome in breast cancer survivorship, yet population-referenced data for working-age women, a group facing distinct social and functional challenges, in Central and Eastern Europe remain scarce. We aimed to quantify HRQoL among Croatian working-age women with breast cancer and to benchmark patient-reported outcomes against national female population norms.
methodsWe conducted a multicentre cross-sectional study in 2024 at two tertiary oncology centres in Croatia. Women aged 18-65 years attending outpatient breast cancer care completed the EQ-5D-5 L (dimensions, EQ-VAS and utility index) and the EORTC QLQ-BR23. EQ-5D-5 L utilities were calculated using the Slovenian value set and compared with age-stratified Croatian female population norms (2022). Group differences were analysed using appropriate non-parametric tests.
resultsIn total, 271 women participated, with 233 included in EQ-5D-5 L analyses. Mean EQ-5D-5 L utility was substantially lower among patients than in the general female population (0.76 vs. 0.91), accompanied by lower EQ-VAS scores (66.2 vs. 84.0). Problems were most frequently reported in pain/discomfort and anxiety/depression. HRQoL declined with age (utility 0.82 to 0.70; p = 0.03) and was significantly lower in women with metastatic disease compared with non-metastatic disease (0.70 vs. 0.77; p = 0.03). Disease-specific assessment revealed pronounced impairments in future perspective and sexual functioning/enjoyment, alongside notable symptom burden related to systemic therapy side effects and arm and breast symptoms.
conclusionWorking-age women with breast cancer in Croatia experience clinically meaningful reductions in HRQoL compared with national population norms, with higher burden among older women and those with metastatic disease. These findings highlight substantial unmet survivorship care needs and support the integration of routine patient-reported outcome monitoring into oncology follow-up, alongside targeted symptom management, psychosocial support, rehabilitation and sexual health care.
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