Chronic Conditions and Utility-Based Health-Related Quality of Life in Adult Childhood Cancer Survivors.
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.
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD) jyeh@hsph.harvard.edu.
Jennifer M
JM
Yeh
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Janel
J
Hanmer
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Zachary J
ZJ
Ward
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Wendy M
WM
Leisenring
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Gregory T
GT
Armstrong
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Melissa M
MM
Hudson
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Marilyn
M
Stovall
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Leslie L
LL
Robison
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Kevin C
KC
Oeffinger
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (JMY, ZJW); University of Pittsburgh Medical Center, Pittsburgh, PA (JH); Fred Hutchinson Cancer Research Center, Seattle, WA (WML); St. Jude Children's Research Hospital, Memphis, TN (GTA, MMH, LLR); University of Texas MD Anderson Cancer Center, Houston, TX (MS); Memorial Sloan Kettering Cancer Center, New York, NY (KCO); Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, MA (LD).
Lisa
L
Diller
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D011788:Quality of Life; D035781:Siblings; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult