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Accepted for/Published in: JMIR Cancer

Date Submitted: Nov 6, 2025
Date Accepted: Apr 20, 2026

The final, peer-reviewed published version of this preprint can be found here:

Quality of Life, Symptom Burden, and Associated Factors Among Patients With Lung Cancer in Sub-Saharan Africa: Cross-Sectional Study

Malale K, Ratshikana M, Sayed AR, Ayeni O, Mathobela P, Rofhiwa R, Blanchard C, Tsitsi M, Osei-Fofie D, Graham A, Dhudha HO, Masalu N

Quality of Life, Symptom Burden, and Associated Factors Among Patients With Lung Cancer in Sub-Saharan Africa: Cross-Sectional Study

JMIR Cancer 2026;12:e87232

DOI: 10.2196/87232

PMID: 42462209

Quality of Life, Symptom Burden, and Associated Factors Among Lung Cancer Patients: A Cross-Sectional Study at Two Teaching Hospitals Across Sub-Saharan Africa

  • Kija Malale; 
  • Mpho Ratshikana; 
  • Abdul-Rauf Sayed; 
  • Oluwatosin Ayeni; 
  • Peedi Mathobela; 
  • Rofhiwa Rofhiwa; 
  • Charmaine Blanchard; 
  • Merika Tsitsi; 
  • Daniel Osei-Fofie; 
  • Anita Graham; 
  • Herry O Dhudha; 
  • Nestory Masalu

ABSTRACT

Background:

Cancer patients in Sub-Saharan Africa (SSA) are diagnosed late partly due to the community's lack of knowledge about the disease, social and cultural factors, health system challenges, and inadequate health care worker knowledge. These delays in diagnosis, as well as inadequate treatment options, contribute to the high mortality from lung cancer in SSA. Quality of life (QoL) is an important outcome measure for cancer patients undergoing treatment.

Objective:

This study aims to describe the common symptoms and QoL of lung cancer patients treated at two different hospitals in SSA, and to investigate the association of demographic and clinical characteristics with global health status (GQoL)

Methods:

This is a cross-sectional study of lung cancer patients at two teaching hospitals in Sub-Saharan Africa: Tanzania (BMC) and South Africa (WITS-CORE). Trained interviewers collected data on demographics, clinical information, and performance status using the Eastern Cooperative Oncological Group Performance Scale (ECOG-PS). Health related QoL was assessed using the 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30).

Results:

A total of 174 lung cancer patients were enrolled across the two sites. The Global Health Status score was low, with a median of 41.67 (range 33.33–41.67), and it varied by site. Patients from WITS-CORE demonstrated higher social functioning scores, while those from BMC reported greater financial difficulties. Low Global Health Status was independently associated with BMC site (aOR = 3.5; 95% CI: 1.3–9.3) and poor performance status (ECOG 3–4) (aOR = 1.6; 95% CI: 0.2–11.2). Furthermore, symptoms such as nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, diarrhoea, and financial struggles were all associated with low Global Health Status.

Conclusions:

QoL among lung cancer patients in SSA is poor. Low QoL is strongly associated with MLCCP study site, poor performance status, and a range of symptoms and financial difficulties. Addressing these factors may help to improve patient outcomes and well-being in SSA.


 Citation

Please cite as:

Malale K, Ratshikana M, Sayed AR, Ayeni O, Mathobela P, Rofhiwa R, Blanchard C, Tsitsi M, Osei-Fofie D, Graham A, Dhudha HO, Masalu N

Quality of Life, Symptom Burden, and Associated Factors Among Patients With Lung Cancer in Sub-Saharan Africa: Cross-Sectional Study

JMIR Cancer 2026;12:e87232

DOI: 10.2196/87232

PMID: 42462209

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