title: Health-related quality of life among breast, prostate, and colorectal cancer patients with end-stage disease.
abstract: OBJECTIVE
  To explore end-stage breast, prostate, and colorectal cancer patients' health-related quality of life (HRQoL); to compare results obtained by different HRQoL instruments; and to explore factors related to impaired HRQoL.
  
  
  METHODS
  A cross-sectional observational study utilized two generic HRQoL instruments, the 15D and the EQ-5D, and a cancer-specific instrument, the EORTC QLQ-C30. Patients were recruited from the Helsinki University Hospital's Department of Oncology and from a local hospice.
  
  
  RESULTS
  Of the 114 palliative care patients included in the analysis, 27 had breast cancer, 30 had prostate cancer, and 57 had colorectal cancer. Of these, 28 % died within 3 months after their response, while 32 % died within three to 6 months, and 39 % died more than 6 months after. Utility values varied widely by instrument: the 15D gave the highest utility values and VAS the lowest (15D: 0.74, EQ-5D: 0.59 and VAS: 55). Patients close to death had lower HRQoL scores independently from the instrument used. The EQ-5D showed a pronounced ceiling effect, with 13 % of patients reporting full health, whereas the corresponding figures for the 15D and VAS were 1 and 0 %, respectively. Fatigue was the most common symptom and also predicted impaired HRQoL most significantly.
  
  
  CONCLUSIONS
  All instruments were applicable for the evaluation of HRQoL among end-stage cancer patients. Fatigue seemed to be the most significant deteriorating factor, whereas clinical and demographic factors had less of an effect on HRQoL.
authors.affiliation: Department of Public Health, Hjelt-Institute, University of Helsinki, Helsinki, Finland, niilo.farkkila@helsinki.fi.
authors.forename: Niilo
authors.initials: N
authors.lastname: Färkkilä
authors.forename: Saku
authors.initials: S
authors.lastname: Torvinen
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.forename: Juha
authors.initials: J
authors.lastname: Hänninen
authors.forename: Kimmo
authors.initials: K
authors.lastname: Taari
authors.forename: Tiina
authors.initials: T
authors.lastname: Saarto
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013727:Terminal Care