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

Abstract

Background Incidence of non‐melanoma skin cancers (NMSCs) is increasing and can significantly impact on quality of life (QOL), yet there are few studies evaluating patient‐reported outcome measures (PROMs) in NMSC populations. We undertook a prospective feasibility study to evaluate a skin cancer‐specific PROM, the Skin Cancer Quality of Life Impact Tool (SCQOLIT), in patients with a new diagnosis of NMSC. Objectives (i) To establish acceptability of SCQOLIT in dermatology clinics, (ii) a descriptive analysis of SCQOLIT scores in NMSC. Methods Patients with histologically confirmed NMSC completed SCQOLIT, EQ‐5D and a transition item. Questionnaires were completed at baseline and 3 months for group 1 (‘low‐risk’ NMSC) and group 2 (‘high‐risk’ NMSC) with additional questionnaires at 6–9 months for group 2. Patients participated in structured interviews. Clinician experience was captured through staff evaluation forms and a focus group. Acceptability and psychometric properties of SCQOLIT were assessed. Results Overall, 318 patients consented to participate. Mean SCQOLIT score at baseline was 5.33, with 2.6% of patients scoring ≥20. No ceiling effects were observed, whilst 13.9% scored 0. Validity was demonstrated against EQ‐5D. Cronbach's alpha 0.84 demonstrated internal consistency. Thirteen patients were interviewed and thought SCQOLIT was comprehensive, captured impact on health‐related QOL and helped express their needs to clinicians. Most clinicians found SCQOLIT ‘very useful’ or ‘useful to some extent’ in facilitating discussions. Conclusions This feasibility study demonstrates that SCQOLIT is acceptable to patients and staff in dermatology skin cancer clinics. The psychometric properties of SCQOLIT confirm its utility in NMSC populations.

Comparison of the Skin Cancer Quality of Life Impact Tool and the Skin Cancer Index Questionnaire in Measurement of Health-Related Quality of Life and the Effect of Patient Education Brochures in Patients with Actinic Keratosis, Non-melanoma Skin Cancer, and Cutaneous Melanoma

“…Finally, our median scores for SCIQ (range 0–100; high scores indicate high HRQoL) and SCQOLIT (range 0–30; low scores indicate high HRQoL) 1 week after surgery compared to Anglo-Saxon authors indicated a significantly lower HRQoL in our patients [ 12 , 13 , 19 , 55 ].…”

“…After 1 month, the 3-cm excision group had significantly poorer mental and physical functioning [ 54 ]. However, these differences disappeared within 6 months except for a persisting poor scar perception in the 3-cm excision group [ 55 ]. A 3-cm excision margin and younger age, female gender, and poor physical and mental health post surgery were associated with poor scar perception [ 54 ].…”

“…Wali et al [ 55 ] reported a median score for the SCQOLIT in British patients of 5.33 (SD 5.32) at baseline. Burdon-Jones [ 19 ] reported a median score for melanoma of 10 (SD 12) and for NMSC of 4 (SD 5) at baseline [ 19 ].…”

“…The SCQOLIT is a short PROM with only 10 items, making it a good candidate for incorporation into busy skin cancer clinics with a low administrative burden [ 19 , 55 ]. The SCQOLIT was validated for NMSC and CM.…”

A structured review of quality of life in advanced and high‐risk cutaneous squamous cell carcinoma shows the need for more studies and better measures

“…Studies employed a number of QoL measures, some generic such as the EQ-5D, 28,29,33 SCQOLIT showed good internal consistency Cronbach's alpha = 0.84 (N = 273) and convergent validity against the EQ-5D (p < 0.001).…”