Predictors of skin-related quality of life after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma

Objective: To identify predictors of skin-related quality of life (QOL) after treatment of nonmelanoma skin cancer (NMSC). Design: Prospective cohort study of consecutive patients with NMSC diagnosed in 1999 and 2000. Setting: University-affiliated private practice and a Veterans Affairs clinic. Patients: A total of 633 patients who responded to a questionnaire before treatment. Main Outcome Measure : Skin-related QOL, measured with the 16-item version of Skindex-16, a validated measure. Skindex-16 scores vary from 0 (best QOL) to 100 (worst QOL) and are reported in 3 domains: symptoms, emotional effects, and effects on functioning. Results: Controlling for treatment group, the strongest independent predictor of skin-related QOL after treatment of NMSC was pretreatment skin-related QOL. Other patient characteristics that predicted better QOL included less comorbidity and better mental health status. No tumor or care characteristic (including location of tumor, size of tumor, site of therapy, or training level of treating clinician [attending physician, resident, or nurse practitioner]) was found to predict better skin-related QOL after treatment of NMSC. Conclusions: Patients with better pretreatment skin-related QOL, less comorbidity, and better mental health status had better skin-related QOL after treatment of NMSC. These findings may be useful for pretreatment assessment and counseling.