Health-related quality of life and associated factors among non-melanoma skin cancer patients: a cross-sectional study

BACKGROUND: Non-melanoma skin cancer (NMSC) is a common malignant tumor that can lead to disability and a high recurrence rate, thus affecting the health-related quality of life (HRQoL) of patients. However, the HRQoL and its associated factors among Chinese patients with NMSC remain unknown. Considering HRQoL is a comprehensive indicator to assess an individual’s health and well-being, as well as to provide a basis for future treatment decisions and care interventions, we investigated Chinese NMSC patients to assess the status of HRQoL, and to explore the associated factors of HRQoL. METHODS: This cross-sectional study was conducted at the largest dermatology hospital in China from November 2017 to February 2022. Participants were over 18 years, diagnosed with NMSC by pathological examination, and able to provide informed consent. A consecutive sampling technique was used and 202 eligible patients with NMSC were surveyed. Dermatology Life Quality Index, general information questionnaire, Athens Insomnia Scale, and Self-rating Anxiety Scale were used to measure their HRQoL and relevant information. Descriptive statistics, non-parametric test and Spearman’s correlation analyses were used to compare the differences and assess the relationships between participants’ demographic and clinical factors, sleep, anxiety, and HRQoL. Multiple linear regression analysis was performed to identify factors associated with HRQoL. RESULTS: A total of 176 NMSC patients (mean age 66 years, including 83 males and 93 females) were included. The median score of HRQoL was 3 [1, 7], and 116 (65.9%) NMSC patients’ HRQoL was negatively affected. The score of the symptom and feeling domain was the highest 2 [1, 3], NMSC patients with squamous cell carcinoma and extramammary Paget disease had a significantly lower HRQoL than patients with basal cell carcinoma (P<0.05). Primary skin diseases, long-term history of mechanical stimulation, poor sleep, and anxiety were the associated factors of the HRQoL, comprising 43.5% of the total variance. CONCLUSIONS: Most patients with NMSC live with poor HRQoL in China. It is necessary to provide timely assessment and develop targeted strategies to improve NMSC patients’ HRQoL, such as multiple forms of health education, psychological care for the target population, and effective measures to improve patients’ sleep.