Validation of a Quality-of-Life Instrument for Patients With Nonmelanoma Skin Cancer

Abstract

To validate a disease-specific quality-of-life instrument-the Skin Cancer Index-intended to measure quality-of-life issues relevant to patients with nonmelanoma skin cancer. Methods: Internal reliability, convergent and divergent validity with existing scales, and factor analyses were performed in a cross-sectional study of 211 patients presenting with cervicofacial nonmelanoma skin cancer to a dermatologic surgery clinic. Results: Factor analyses of the Skin Cancer Index confirmed a multidimensional scale with 3 distinct subscales-emotional, social, and appearance. Excellent internal validity of the 3 subscales was demonstrated. Substantial evidence was observed for convergent validity with the Dermatology Life Quality Index, Rosenberg Self-Esteem Scale, Lerman's Cancer Worry Scale, and Medical Outcomes Survey Short-Form 12 domains for vitality, emotion, social function, and mental health. Conclusions: These findings validate a new diseasespecific quality-of-life instrument for patients with cervicofacial nonmelanoma skin cancer. Studies on the responsiveness of the Skin Cancer Index to clinical intervention are currently under way.

Psychological outcomes following surgical excision of facial skin cancers

“…Quality of life (QOL) variables were assessed using the Skin Cancer Index (SCI) [12]. The SCI is a recently developed, 15-item, validated, disease specific quality of life instrument.…”

Patient Perception of Imiquimod Treatment for Actinic Keratosis and Superficial Basal Cell Carcinoma in 202 Patients

“…The Skindex-17 is probably not specific enough to capture specific skin cancer patient concerns. Although the SCI was developed specifically for BCC and SCC patients and demonstrated impairment on the Emotional and the Appearance subscales in the validation study, in our study standardized scores (0 to 100) were all >75 [18]. This observation implicates that HRQoL impairment in our population (treated with imiquimod) is less than in patients who will have to be treated surgically, or that the SCI is only suitable for use in patients being treated surgically, since it was developed in a tertiary care Mohs surgery clinic [19].…”

Interpretation of the Skin Cancer Quality of Life Score: A Validated Quality of Life Questionnaire for Non-Melanoma Skin Cancer

“…Furthermore, it may help identifying patients in special need for attention. None of the two other existing NMSC-specific HRQoL questionnaires have reported clinical cut-off scores [15,16]. …”

“…Only 2 HRQoL questionnaires aimed specifically at NMSC have been published, the first aimed at NMSC in the face and neck and the second non-metastatic skin cancer (malignant melanoma or NMSC). Both were developed for and tested on surgically treated patients, but only validation using methods from the classical test theory has been considered [15,16]. To assess the burden of NMSC the Skin Cancer Quality of Life (SCQoL) was recently developed and validated using both classical and modern test theory [17,18].…”