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. 2016 Apr 21;108(9):djw046.
doi: 10.1093/jnci/djw046. Print 2016 Sep.

Chronic Conditions and Utility-Based Health-Related Quality of Life in Adult Childhood Cancer Survivors

Jennifer M Yeh  1 , Janel Hanmer  2 , Zachary J Ward  2 , Wendy M Leisenring  2 , Gregory T Armstrong  2 , Melissa M Hudson  2 , Marilyn Stovall  2 , Leslie L Robison  2 , Kevin C Oeffinger  2 , Lisa Diller  2
Affiliations

Chronic Conditions and Utility-Based Health-Related Quality of Life in Adult Childhood Cancer Survivors

Jennifer M Yeh et al. J Natl Cancer Inst. .

Abstract

Health utility, a summary measure of quality of life, has not been previously used to compare outcomes among childhood cancer survivors and individuals without a cancer history. We estimated health utility (0, death; 1, perfect health) using the Short Form-6D (SF-6D) in survivors (n = 7105) and siblings of survivors (n = 372) (using the Childhood Cancer Survivor Study cohort) and the general population (n = 12 803) (using the Medical Expenditures Panel Survey). Survivors had statistically significantly lower SF-6D scores than the general population (mean = 0.769, 95% confidence interval [CI] = 0.766 to 0.771, vs mean = 0.809, 95% CI = 0.806 to 0.813, respectively, ITALIC! P< .001, two-sided). Young adult survivors (age 18-29 years) reported scores comparable with general population estimates for people age 40 to 49 years. Among survivors, SF-6D scores were largely determined by number and severity of chronic conditions. No clinically meaningful differences were identified between siblings and the general population (mean = 0.793, 95% CI = 0.782 to 0.805, vs mean = 0.809, 95% CI = 0.806 to 0.813, respectively). This analysis illustrates the importance of chronic conditions on long-term survivor quality of life and provides encouraging results on sibling well-being. Preference-based utilities are informative tools for outcomes research in cancer survivors.

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Figures

Figure 1.
Figure 1.
Comparison of age-specific SF-6D utility scores among Childhood Cancer Survivor Study (CCSS) survivors, CCSS siblings, and Medical Expenditures Panel Survey general population by sex. Similar to the general population, SF-6D utility scores for survivors and siblings decreased with age for both women (A) and men (B) . CCSS = Childhood Cancer Survivor Study; MEPS = Medical Expenditures Panel Survey; SF-6D = short form-6D.
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