Persons with Cancer in India: Role of Social Determinants of Health in Attaining Health-Related Quality of Life

Milincy Mathews



Background: As cancer has become one of the ten leading causes of death in India, quality of life of the persons with cancer is taken into consideration of health policies along with the medical care. When thinking the complex issues that cancer presents it is important to set a realistic goal of care to provide a life that is comfortable, functional and satisfying as possible. Implementation strategies and provision of programmes vary according to context as different factors determine the nature and complexity of the illness experience.

Objectives and methods: This paper aims to discuss the social determinants of cancer (SDH of Cancer) and how it is associated with the health related quality of life (HRQoL) of cancer affected persons by reviewing the available secondary data gathered from medical journals, research papers, reports and website content. The author conjointly focuses the various views through that SDH influences cancer, rising HRQoL by addressing social determinants. Findings: The author describes the critical issues in addressing social determinants of cancer in India in various levels. The paper also mentions about the state and civil society response towards social determinants of cancer in India. Conclusion: The paper concludes with suggestions which include addressing SDH which influence cancer in Indian context, integration of SDH into programmes and policies to improve quality of life of persons with cancer, review successful models of care which incorporated SDH and need for training and research in this area.  


Health-related Quality of Life, Social Determinants of Health, Persons with Cancer, Indian context

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Anderson, K. L., & Burckhardt, C. S. (1999). Conceptualization and measurement of quality of life as an outcome variable for health care intervention and research. Journal of Advanced Nursing, 29 (2), 298–306.

Bahrami, M. (2011). Meanings and aspects of quality of lifefor cancer patients: A descriptive exploratory qualitative study. Contemporary Nurse , 39 (1), 75-84.

Berkman, L.F., and I. Kawachi. 2000. Social Epidemiology. New York: Oxford University Press.

Boling, W., Fouladi, R. T., & Basen-Engquist, K. (2003). Health-related quality of life in gynaecological oncology: Instruments and psychometric properties. International Journal of Gynecological Cancer, 13(1), 5–14.

Bowling, A. (2001). Measuring Disease. Philadelphia: Open University Press.

Bonomi, A. E., Patrick, D. L., Bushnell, D.M., & Martin, M. (2000). Validation of the United States’ version of the World Health Organization Quality of Life (WHOQOL) instrument. Journal of Clinical Epidemiology,53(1), 1–12.

Bottomley, A. (2002). The cancer patient and quality of life. The Oncologist, 7(2), 120–125.

Brunelli, C., Costantini, M., Di Giulio, P.,Gallucci, M., Fusco, F., Miccinesi, G., et al.(1998). Quality-of-life evaluation: Whendo terminal cancer patients and health-careproviders agree? Journal of Pain and SymptomManagement, 15(3), 151–158.

Carr, A. J., Gibson, B., & Robinson, P. G.(2001). Measuring quality of life: Is quality of life determined by expectations or experience? British Medical Journal, 322(7296), 1240–1243.

Cella, D. F., Chang, C. H., Lai, J. S., & Webster, K. (2002). Advances in quality of life measurements in oncology patients. Seminars in Oncology, 29(3 Suppl. 8), 60–68.

Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: World Health Organization.

Erik Blas, L. G. (2008). Addressing social determinants of health inequities:what can the state and civil society do? Health Policy (372), 1684-89.

Fallowfi eld, L. (2002). Quality of life: A new perspective for cancer patients. Nature Reviews Cancer, 2(11), 873–879.

Fayers, P., & Machin, D. (2000). Quality of life: Assessment, analysis and interpretation.Chichester, UK: John Wiley & Sons, Ltd.

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin D Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127: 2893–917. WHOdb/WHOdb.htm (accessed Sept 3, 2011).

Ferrell, B. R., Dow, K. H., & Grant, M. (1995). Measurement of the quality of life in cancer survivors. Quality of Life Research, 4(6), 523–531.

Hendry, F., & McVittie, C. (2004). Is quality of life a healthy concept? Measuring and understanding life experiences of older people. Qualitative Health Research, 14(7), 961–975.

Holmes, S., & Dickerson, J. (2003). The quality of life: Design and evaluation of a self- assessment instrumentfor use with cancer patients. International Journal of Nursing Studies, 40(5), 515–520.

Jha P. Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer 2009; 9: 655–64.

Kelly PM, Morgan A, Bonnefoy J, Butt J, Bergman V. The social determinants of health: developing an evidence base for political action—final report of the measurement and evidence knowledge network of the Commission on Social Determinants of Health. Geneva: World Health Organization, 2007. Sept 30, 2008).

Kindig, D.A. 2007. Understanding Population Health Terminology. The Milbank Quarterly 85(l):139-6l.

King, C. R., Ferrell, B. R., Grant, M., & Sakurai, C. (1995). Nurses’ perceptions of the meaning of quality of life for bone marrow transplant survivors.Cancer Nursing, 18(2), 118–129.

Krieger, A. N. (2005). Defining and Investigating Social Disparities in Cancer: Critical Issues. Cancer Causes & Control , Vol. 16, No. 1, pp. 5-14.

Labonté R, Schrecker T. Globalization and social determinants of health: introduction and methodological background (part 1 of 3). Global Health 2007; 3: 5.

Mari Bhat PN. Completeness of India’s sample registration system: an assessment using the general growth balance method. Popul Stud 2002; 56: 119–34.

Marmot, M. (2005). Social determinants of health inequalities. Public Health , 365: 1099–104.

Mechanic, D. (2000). Rediscovering the social determinants of health. Health Affairs, 19(3), 269–276.

Mechanic, D., & Tanner, J. (2007). Vulnerable people, groups, and populations: societal view. Health Affairs, 26(5), 1220–1231.

Movsas, B. (2003). Quality of life in oncologytrials: A clinical guide. Seminars in Radiation Oncology, 13(3), 235–247.

National Cancer Registry Programme. Three-Year Report ofPopulation Based Cancer Registries 2006–2008: Incidence and Distribution of Cancer. Bangalore: Indian Council of Medical Research, 2010.

Registrar General of India and Centre for Global Health Research.Causes of death in India, 2001–2003: Sample Registration System.New Delhi: Government of India, 2009.

Registrar General of India. Sample registration system statistical report 2009. New Delhi: Registrar General of India, 2010.

Registrar General of India. Special fertility and mortality survey,1998: a report of 1•1 million households. New Delhi: Registrar General of India, 2005.

Schumacher, M., Olschewski, M., & Schulgen,G. (1991). Assessment of quality of life inclinical trials. Statistics in Medicine, 10(12),1915–1930.

Sivanandan V. An assessment of the completeness of death registration in India over the periods 1975–1978 and 1996–1999 under the generalized population model: an analysis based on SRS data Mumbai, India. Mumbai: International Institute for Population Sciences, 2004.

Stacy M. Carter, L. C. (2009). Writing social determinants into and out of cancer control: An assessment. Social Science & Medicine , 68, 1448-1455.

Tarlov, A. (1996). Social determinants of health: the sociobiological translation. In D. Blane, E. Brunner, & R. Wilkinson (Eds.), Health and social organization (pp. 71–93). London: Routledge.

Wilson, K. A., Dowling, A. J., Abdolell, M., & Tannock, I. F. (2000). Perception of quality of life by patients, partners and treating physicians. Quality of Life Research, 9(9), 1041–1052. World Health Organization. (1986). Ottawa charter for health promotion. Geneva:World Health Organization.

World Health Organization. (2002). National cancer control programmes: Policies and managerial guidelines (2nd ed.). Geneva: World Health Organization.

World Health Organization. (2006). Cancer control, knowledge into action, WHO guide for effective programmes: Planning. Geneva: World Health Organization.

World Health Organization. (2007). Interim statement of the Commission on Social Determinants of Health.


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