title: The skin cancer index: clinical responsiveness and predictors of quality of life.
abstract: OBJECTIVE
  To establish the clinical responsiveness of the Skin Cancer Index (SCI), a new disease-specific quality of life (QOL) instrument, and to assess demographic and clinical factors which impact QOL in patients with nonmelanoma skin cancer (NMSC).
  
  
  METHODS
  Prospective study of 183 patients with NMSC of the face and neck referred to a tertiary care Mohs surgery clinic.
  
  
  METHODS
  The SCI is a 15 item, validated, disease-specific QOL instrument with 3 distinct subscales, Emotion, Social, and Appearance. Higher scores reflect better QOL. The SCI and the Dermatology Life Quality Index (DLQI), a general dermatology instrument, was administered at initial consultation and 4 months after surgical treatment. Multivariate analysis was conducted to assess demographic and clinical factors predictive of QOL for both instruments.
  
  
  RESULTS
  The SCI total score and all three subscale scores increased with treatment, demonstrating strong evidence of responsiveness over time (P < .001) in contrast with the DLQI (P = .46). Predictors of poorer QOL for the SCI included female sex and cancers located on the lip. Patients who demonstrated greatest improvement in QOL with treatment included those who were younger (<50 yr) and had lower reported household income. Also, first time NMSC patients and those patients who underwent less extensive reconstructions demonstrated greater improvements in QOL.
  
  
  CONCLUSIONS
  The SCI is a sensitive and responsive QOL instrument for patients with NMSC. Distinct demographic and clinical variables that impact QOL have been demonstrated using this multidimensional, disease-specific instrument.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. jrhee@mcw.edu
authors.forename: John S
authors.initials: JS
authors.lastname: Rhee
authors.forename: B Alex
authors.initials: BA
authors.lastname: Matthews
authors.forename: Marcy
authors.initials: M
authors.lastname: Neuburg
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.forename: Mary
authors.initials: M
authors.lastname: Burzynski
authors.forename: Ann B
authors.initials: AB
authors.lastname: Nattinger
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D012878:Skin Neoplasms / Q000523:psychology*