Health-Related Quality of Life Associated with Barrett’s Esophagus and Cancer
Norma B. Bulamu
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, 5041 Adelaide, SA, Australia
Search for more papers by this authorCorresponding Author
Gang Chen
- [email protected]
- [email protected]
- +61-425811029
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, 5041 Adelaide, SA, Australia
Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia
Tel.: +61-425811029, [email protected], [email protected]Search for more papers by this authorJulie Ratcliffe
Institute of Choice, Business School, University of South Australia, Adelaide, Australia
Search for more papers by this authorAnn Schloite
Discipline of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorTim Bright
Discipline of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorDavid I. Watson
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, 5041 Adelaide, SA, Australia
Discipline of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorNorma B. Bulamu
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, 5041 Adelaide, SA, Australia
Search for more papers by this authorCorresponding Author
Gang Chen
- [email protected]
- [email protected]
- +61-425811029
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, 5041 Adelaide, SA, Australia
Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia
Tel.: +61-425811029, [email protected], [email protected]Search for more papers by this authorJulie Ratcliffe
Institute of Choice, Business School, University of South Australia, Adelaide, Australia
Search for more papers by this authorAnn Schloite
Discipline of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorTim Bright
Discipline of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorDavid I. Watson
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, 5041 Adelaide, SA, Australia
Discipline of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorAbstract
Background
Research assessing health-related quality of life (HRQoL) which can be applied to economic evaluation in Barrett’s esophagus (BE) and esophageal cancer is limited. This study derived health state utilities for various ‘stages’ of BE and Cancer.
Methods
A cross-sectional survey was conducted, including patients with non-dysplastic BE, low-grade dysplasia, high-grade dysplasia, or esophageal adenocarcinoma. HRQoL was assessed using generic instruments—EQ-5D-5L and SF-36, and a cancer-specific instrument—EORTC QLQ-C30. Outcomes were compared for health states following different treatments. Correlations and agreements for the three instruments were investigated using Spearman’s correlation coefficient (r) and intraclass correlation coefficient (ICC).
Results
A total of 97 respondents (80% male, mean age 68 years) returned questionnaires. The mean (standard deviation) health state utilities for the total sample were 0.79 (0.24) for the EQ-5D-5L, 0.57 (0.29) for the SF-6D (derived from SF-36) and 0.73 (0.20) for the QLU-C10D (derived from EORTC QLQ-C30). There were strong correlations (r > 0.80) and absolute agreement (except EQ-5D-5L and SF-6D with an ICC of 0.69) among the three instruments. No significant differences were observed for different stages of BE or interventions. However, following surgery for cancer patients reported better psychological well-being than those under surveillance or following endoscopic treatments.
Conclusion
HRQoL for BE surveillance and following cancer treatment was similar. Esophagectomy was associated with better psychological functioning, and this might be attributed to a reduction in the perceived risk of cancer. The correlation between the EORTC QLU-C10D and the other health state utility instruments supports the validity of this new instrument.
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