Which dimensions of health-related quality of life are altered in patients attending the different gynecologic oncology health care settings?

BACKGROUND. we evaluated the feasibility of measuring health-related quality of life (HRQOL) in a gynecologic oncology clinic by using an instrument that is nonspecific for cancer patients. Our aim was to study whether the HRQOL perception of cancer patients differed from general population norms for the same age and gender and if it varied across cancer type, cancer status, age, health care setting, and reason for the encounter. METHODS. Participants in this study included 115 women between the ages of 21 and 83 years who were referred to a university hospital for ovarian, endometrial, and cervical carcinoma. They completed the SF-36 questionnaire. Mean results for the entire sample, for different disease status (primary vs. progressive/ recurrent disease), and reason for encounter (surgery, preoperative, postoperative, palliative chemotherapy, and follow-up) were compared with age-specific expected mean values for each SF-36 scale, based on published Italian reference values for the healthy population. RESULTS. Patients' attitude to the questionnaire was generally good. Mean values on the SF-36 scales varied. Role (Physical and Emotional) scales showed the highest differences from the expected age-specific values in all situations. Patients with primary disease showed little or no differences for the other six scales from the expected values, whereas a significant 10-point mean decrease in every SF-36 scale was recorded for patients with progressive/ recurrent disease. A biologic interaction among cervical carcinoma, age, and disease status was found in multivariate models, showing worst scores for patients with progressive/ recurrent cervical carcinoma on almost all scales. CONCLUSIONS. Administration of generic HRQOL questionnaires in specialist health care delivery settings is feasible and well accepted and may help physicians and nurses to look beyond "what's wrong" in their patients. Cancer 2002;95: 2500-7. (C) 2002 American Cancer Society.