Patient‐reported health outcomes in patients with non‐melanoma skin cancer and actinic keratosis: results from a large‐scale observational study analysing effects of diagnoses and disease progression

Abstract

BackgroundNon‐melanoma skin cancer (NMSC) and actinic keratosis (AK) are very common among fair‐skinned individuals. A disease continuum from AK to squamous cell carcinoma (SCC) has been frequently postulated. AK and NMSC may influence quality of life (QL) of patients, and it can be suspected that disease progression entails a QL reduction. The purpose of this study was to document QL in patients with NMSC and AK using the health‐outcome questionnaire EQ‐5D‐5L.MethodsThe study was designed as a non‐interventional, prospective, cross‐sectional study. Patients with AK, SCC, basal cell carcinoma (BCC) or multiple diagnoses were enrolled in this study in 29 dermatological centres across Germany. Patients were asked to complete the EQ‐5D‐5L (compromising EQ Index and EQ VAS), and the dermatologists provided diagnosis, disease history and treatment data.ResultsA total of 1184 patients were enrolled and diagnosed as follows: 73% AK, 49% BCC and 17% SCC. 66% had a single diagnosis, 28% two different diagnoses and 6% three different diagnoses. QL was strongly associated with patients’ diagnosis. Patients with a single AK diagnosis had significantly higher mean EQ VAS (78) than patients with BCC (74), SCC (72), and BCC plus SCC (69), P < 0.050. When the effects of disease progression were calculated, patients with AK plus SCC reported significantly less mean EQ VAS (71) than patients with a single AK diagnosis (78), P < 0.011.ConclusionsWhile rarely being imminently life‐threatening, NMSC and AK have an impact on QL as quantified by the EQ‐5D‐5L. This impact is associated with diagnosis (AK vs. NMSC) and clinical progression (AK vs. AK plus SCC). Both lead to a clear decline in QL. This shows that disease progression is perceived and judged as detrimental by patients and that AK and NMSC should be diligently treated to preserve and restore QL.

Use of the Skin Cancer Quality of Life Impact Tool (SCQOLIT) – a feasibility study in non‐melanoma skin cancer

“…Patient‐reported outcome measures (PROMs) offer potential to improve the quality of dermatology services in the National Health Service (NHS) by providing validated evidence from the patient perspective. The incidence of non‐melanoma skin cancers (NMSCs) is exponentially increasing and although rarely life‐threatening, both disease and treatments can have significant impact on health‐related quality of life (HRQOL) . Evaluating PROMs in NMSC is essential because of the impact on health and the burden on healthcare resources, yet there are few studies to date.…”

Different outdoor professions have different risks – a cross‐sectional study comparing non‐melanoma skin cancer risk among farmers, gardeners and mountain guides

“…Non‐melanoma skin cancer (NMSC) is the most common cancer worldwide with a tremendous individual and socio‐economic impact . Solar UV‐radiation (UVR) exposure is the main risk factor for NMSC, which has led to the official recognition of NMSC as occupational disease for outdoor workers in some countries including Australia, Denmark, France, Germany, Italy and Romania .…”

“…Non-melanoma skin cancer (NMSC) is the most common cancer worldwide with a tremendous individual and socioeconomic impact. [1][2][3][4] Solar UV-radiation (UVR) exposure is the main risk factor for NMSC, which has led to the official recognition of NMSC as occupational disease for outdoor workers in some countries including Australia, Denmark, France, Germany, Italy and Romania. 2,[5][6][7] In Germany, only squamous cell carcinoma and more than five actinic keratoses per year were accepted of the many different subtypes of NMSC 3,4 as occupational disease.…”

Quality of life measurement in skin cancer patients: literature review and position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes, Melanoma and Non‐Melanoma Skin Cancer

“…109 BCC and SCC patients reported higher quimp in comparison with actinic keratosis patients using the EQ-5D. 117 There was a higher impact of psychosocial aspects reported by NMSC and cutaneous lymphoma patients than by melanoma patients.…”