Health-related quality of life in elderly survivors of uncommon cancers

BACKGROUND: Patient-reported outcomes (PROs) research among cancer survivors has historically been confined to studies conducted on individuals with breast cancer and, to a lesser extent, individuals with prostate, colorectal, and lung cancer. Much less is known about PROs for individuals diagnosed with less common cancers. We report the health-related quality of life (HRQOL) in Medicare beneficiaries with kidney, bladder, pancreas, upper gastrointestinal, oral, uterine, cervical, thyroid cancer, melanoma, chronic leukemia, and non-Hodgkin lymphoma.

METHODS: Using data linked from the Surveillance Epidemiology and End Results United States cancer registry system and the Centers for Medicaid & Medicare Services Medicare Health Outcomes Survey (MHOS), we report HRQOL physical and mental health component summary scores (PCS and MCS) estimated using the Veterans RAND 12-item survey. Our analytic sample included 9550 individuals 65 and older who were diagnosed with the previously listed cancers, enrolled in Medicare Advantage plans and responded to the MHOS between 1998-2007.

RESULTS: Across all cancer sites, physical summary scores were clinically and statistically significantly lower from population normative values, ranging from 30 (SD =11) for multiple myeloma to 41 for melanoma (SD=12). In contrast, across the disease sites, mean MCS scores were generally preserved, with scores ranging from 47 (SD=12) for pancreatic cancer to 53 (SD=9) for melanoma.

CONCLUSION: Documenting HRQOL levels in elderly cancer survivors is an important first step in identifying sub-populations most likely to benefit from interventions. Ongoing PRO surveillance is necessary to create more comprehensive assessments of elderly patient experiences and suggest more patient-centered interventions.