title: Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms.
abstract: To examine the health-related quality of life (HRQL) in long-term head and neck (H&N) cancer survivors compared with general population norms. HRQL was assessed with three standardized questionnaires: the SF-36 Health Survey (Short Form 36) and the EORTC QLQ-C30 and QLQ-H&N35 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, -Core 30 and -Head and Neck 35 cancer module). Altogether 135 H&N cancer patients (mean age 62 years, 31% females) of 151 survivors (89% acceptance) from a longitudinal HRQL study (n = 232) were included 3 years after diagnosis. The H&N cancer patients' SF-36 scores did not differ significantly from those of an age- and sex-matched sample (n = 871) from the Swedish normative population, except on the role-physical functioning scale. On the other hand, treatment-related side-effects and disease-specific problems (e.g., swallowing, local pain and dry mouth) measured by the H&N cancer module were, with few exceptions, significantly worse than norm values. Gender comparisons revealed that female H&N cancer patients generally scored better than the norms on both the SF-36 and the EORTC QLQ-C30, while the male patients scored significantly worse on most SF-36 scales. Patients > or =65 years more often scored worse than the norm than did patients <65. Clinically relevant differences were found on the majority of SF-36 scales in comparison of tumour sites, however, comparisons of patients with small (stage I+II) versus advanced (stage III+IV) tumours revealed few differences. Three years after diagnosis H&N cancer patients still suffer significant functional limitations/problems related to their disease and its treatment but these problems do not generally affect their overall HRQL. Tumour stage no longer differentiates HRQL at 3 years, however, factors related to the patients' age, gender and location of the tumour appear to have bearing on their reported health status.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Hammerlid
authors.forename: C
authors.initials: C
authors.lastname: Taft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003371:Cough / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000150:complications / Q000523:psychology; D009367:Neoplasm Staging; D009664:Norway; D010146:Pain / Q000209:etiology; D010610:Pharyngeal Neoplasms / Q000150:complications / Q000523:psychology; D011159:Population Surveillance; D011788:Quality of Life; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013548:Sweden; D014076:Tooth Diseases / Q000209:etiology