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The Skin Cancer Index: Clinical Responsiveness and Predictors of Quality of Life
Author(s) -
Rhee John S.,
Matthews B. Alex,
Neuburg Marcy,
Logan Brent R.,
Burzynski Mary,
Nattinger Ann B.
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e31802e2d88
Subject(s) - medicine , quality of life (healthcare) , skin cancer , dermatology life quality index , disease , multivariate analysis , physical therapy , cancer , nursing
Objective: To establish the clinical responsiveness of the Skin Cancer Index (SCI), a new disease‐specific quality of life (QOL) instrument, and to assess demographic and clinical factors which impact QOL in patients with nonmelanoma skin cancer (NMSC). Study Design: Prospective study of 183 patients with NMSC of the face and neck referred to a tertiary care Mohs surgery clinic. Methods: The SCI is a 15 item, validated, disease‐specific QOL instrument with 3 distinct subscales, Emotion, Social, and Appearance. Higher scores reflect better QOL. The SCI and the Dermatology Life Quality Index (DLQI), a general dermatology instrument, was administered at initial consultation and 4 months after surgical treatment. Multivariate analysis was conducted to assess demographic and clinical factors predictive of QOL for both instruments. Results: The SCI total score and all three subscale scores increased with treatment, demonstrating strong evidence of responsiveness over time ( P < .001) in contrast with the DLQI ( P = .46). Predictors of poorer QOL for the SCI included female sex and cancers located on the lip. Patients who demonstrated greatest improvement in QOL with treatment included those who were younger (<50 yr) and had lower reported household income. Also, first time NMSC patients and those patients who underwent less extensive reconstructions demonstrated greater improvements in QOL. Conclusion: The SCI is a sensitive and responsive QOL instrument for patients with NMSC. Distinct demographic and clinical variables that impact QOL have been demonstrated using this multidimensional, disease‐specific instrument.