title: Health-related quality of life and utilities in gastric premalignant conditions and malignant lesions: a multicentre study in a high prevalence country.
abstract: OBJECTIVE
  A recent review of economic studies relating to gastric cancer revealed that authors use different tests to estimate utilities in patients with and without gastric cancer. Our aim was to determine the utilities of gastric premalignant conditions and adenocarcinoma with a single standardized health measure instrument.
  
  
  METHODS
  Cross-sectional nationwide study of patients undergoing upper endoscopy (n=1,434) using the EQ-5D-5L quality of life (QoL) questionnaire.
  
  
  RESULTS
  According to EQ-5D-5L, utilities in individuals without gastric lesions were 0.78 (95% confidence interval: 0.76-0.80), with gastric premalignant conditions 0.79 (0.77-0.81), previously treated for gastric cancer 0.77 (0.73-0.81) and with present cancer 0.68 (0.55-0.81). Self-reported QoL according to the visual analogue scale (VAS) for the same groups were 0.67 (0.66-0.69), 0.67 (0.66-0.69), 0.62 (0.59-0.65) and 0.62 (0.54-0.70) respectively. Utilities were consistently lower in women versus men (no lesions 0.71 vs. 0.78; premalignant conditions 0.70 vs. 0.82; treated for cancer 0.72 vs. 0.78 and present cancer 0.66 vs. 0.70).
  
  
  CONCLUSIONS
  The health-related QoL utilities of patients with premalignant conditions are similar to those without gastric diseases whereas patients with present cancer show decreased utilities. Moreover, women had consistently lower utilities than men. These results confirm that the use of a single standardized instrument such as the EQ-5D-5L for all stages of the gastric carcinogenesis cascade is feasible and that it captures differences between conditions and gender dissimilarities, being relevant information for authors pretending to conduct further cost-utility analysis.
authors.affiliation: Center for Research in Health Technologies and Information Systems, Faculty of Medicine,Porto University; Gastroenterology Dept., Portuguese Oncology Institute of Coimbra,Portugal. miguel.areia75@gmail.com.
authors.forename: Miguel
authors.initials: M
authors.lastname: Areia
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Coimbra, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Alves
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Coimbra, Portugal.
authors.forename: Daniel
authors.initials: D
authors.lastname: Brito
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Coimbra, Portugal.
authors.forename: Ana Teresa
authors.initials: AT
authors.lastname: Cadime
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Coimbra, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Carvalho
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Coimbra, Portugal.
authors.forename: Sandra
authors.initials: S
authors.lastname: Saraiva
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Lisbon, Portugal.
authors.forename: Sara
authors.initials: S
authors.lastname: Ferreira
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Lisbon, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Moleiro
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Lisbon, Portugal.
authors.forename: António Dias
authors.initials: AD
authors.lastname: Pereira
authors.affiliation: Gastroenterology Dept., Santa Luzia Hospital - Viana do Castelo (Local Health Unit of Alto Minho), Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Carrasquinho
authors.affiliation: Gastroenterology Dept., Santa Luzia Hospital - Viana do Castelo (Local Health Unit of Alto Minho), Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Lopes
authors.affiliation: Gastroenterology Dept., Santa Luzia Hospital - Viana do Castelo (Local Health Unit of Alto Minho), Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Ramada
authors.affiliation: Center for Research in Health Technologies and Information Systems, Faculty of Medicine, Porto University; Gastroenterology Dept., Santo António General Hospital, Hospital Centre of Porto; Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Marcos-Pinto
authors.affiliation: Gastroenterology Dept., Santo António General Hospital, Hospital Centre of Porto; Institute of Biomedical Sciences Abel Salazar,University of Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Pedroto
authors.affiliation: Gastroenterology Dept., Hospital Unit of Portimão (Hospital Center of Western Algarve), Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Contente
authors.affiliation: Gastroenterology Dept., Hospital Unit of Portimão (Hospital Center of Western Algarve), Portugal.
authors.forename: Liliana
authors.initials: L
authors.lastname: Eliseu
authors.affiliation: Gastroenterology Dept., Hospital Unit of Portimão (Hospital Center of Western Algarve), Portugal.
authors.forename: Ana Margarida
authors.initials: AM
authors.lastname: Vieira
authors.affiliation: Gastroenterology Dept., Hospital Unit of Portimão (Hospital Center of Western Algarve), Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Sampaio
authors.affiliation: Gastroenterology Dept., Hospital Unit of Portimão (Hospital Center of Western Algarve), Portugal.
authors.forename: Helena Tavares
authors.initials: HT
authors.lastname: Sousa
authors.affiliation: Gastroenterology Dept., Coimbra University Hospital Center; Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Almeida
authors.affiliation: Gastroenterology Dept., Coimbra University Hospital Center; Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gregório
authors.affiliation: Gastroenterology Dept., Coimbra University Hospital Center; Portugal.
authors.forename: Francisco
authors.initials: F
authors.lastname: Portela
authors.affiliation: Gastroenterology Dept., Coimbra University Hospital Center; Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Sofia
authors.affiliation: Gastroenterology Dept., Portuguese Oncology Institute of Porto, Portugal.
authors.forename: Vânia
authors.initials: V
authors.lastname: Braga
authors.affiliation: Gastroenterology Dept., West Lisbon Hospital Centre, Lisbon, Portugal.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Baginha
authors.affiliation: Gastroenterology Dept., West Lisbon Hospital Centre, Lisbon, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Bana e Costa
authors.affiliation: Gastroenterology Dept., West Lisbon Hospital Centre, Lisbon, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Chagas
authors.affiliation: Gastroenterology Dept., West Lisbon Hospital Centre, Lisbon, Portugal.
authors.forename: Luís Lebre
authors.initials: LL
authors.lastname: Mendes
authors.affiliation: Gastroenterology Dept., West Lisbon Hospital Centre, Lisbon, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Magalhães-Costa
authors.affiliation: Gastroenterology Dept., West Lisbon Hospital Centre, Lisbon, Portugal.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Matos
authors.affiliation: Center for Research in Health Technologies and Information Systems, Faculty of Medicine, Porto University; Gastroenterology Dept., Portuguese Oncology Institute of Porto, Portugal.
authors.forename: Francisco Rocha
authors.initials: FR
authors.lastname: Gonçalves
authors.affiliation: Center for Research in Health Technologies and Information Systems, Faculty of Medicine, Porto University; Gastroenterology Dept., Portuguese Oncology Institute of Porto, Portugal.
authors.forename: Mário
authors.initials: M
authors.lastname: Dinis-Ribeiro
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D005757:Gastritis, Atrophic / Q000453:epidemiology / Q000473:pathology / Q000523:psychology*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000523:psychology*; D011795:Surveys and Questionnaires