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Background  Non‐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.    Methods  The 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.    Results  A 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.    Conclusions  While 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 .

journal of the european academy of dermatology and venereology

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