The associations of comorbidities and consumption of fruit and vegetable with quality of life among stomach cancer survivors.

BACKGROUND
Stomach cancer survivors (SCS) often carry the dual burden of the cancer itself and other comorbidities; meanwhile, they are highly motivated to seek health advice about lifestyles to improve their health and quality of life (QOL). The associations of the comorbidity and the consumption of vegetable and fruit with QOL remain even less clear among the SCS. This study aimed to investigate the associations of comorbidities and consumption of fruit and vegetable with QOL among SCS.

METHODS
A cross-sectional study was conducted among 969 SCS between April and July 2015 in Shanghai, People's Republic of China. Data were collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, comorbidities and fruit and vegetable consumption, and a simplified Chinese version of the European Organization for Research and Treatment quality of life version 3 (EORTC QLQ-C30) questionnaire. In order to mitigate the bias caused by confounding factors, multiple linear regression models were employed to calculate the adjusted means of QOL scores.

RESULTS
The proportion of participants without any comorbidity was only 23.3%, and the most common comorbidity among SCS was digestive diseases (49.8%). Participants with comorbidity generally reported lower scores for global health and functioning subscales and higher scores for symptom in EORTC QLQ-C30 compared to participants without comorbidity, indicating poorer QOL. Higher scores in most functioning subscales and lower scores in some symptoms subscales were found in participants (38.7%) who ate more than 250 g vegetables every day, compared to participants with less vegetable consumption, and in participants (58.1%) who ate fruit every day, compared to participants who didn't eat fruit every day indicating better QOL.

CONCLUSIONS
The comorbidities are common health problems among SCS and have significantly negative influence on QOL, and participants with comorbidities generally reported lower QOL scores. The enough vegetables and fruit consumption are positively associated with QOL of SCS. These findings suggested that a multidisciplinary team approach and a variety of delivery systems are needed to address the medical, psychosocial, and lifestyle components for enriching patient-centered care among SCS.