Health Related Quality of Life (HRQoL) in Swedish Relapse Free Breast Cancer Patients. A Study of EQ5D and TTO in a Patient Advocacy Population.
Authors: Wilking N. , Bernow M. , Kossler I. , Wilking U. , Jonsson B. 
Published: December 2010

Abstract
Health Related Quality of life (HRQoL) factors are central in all cancer therapy. We have examined two HRQoL instruments, EQ5D and TTO in women treated for breast cancer and free of relapse.The participants were all members Swedish breast cancer advocacy group BRO. The aim of this study was to evaluate HRQoL in relation to age, time of diagnosis and compare this with healthy Swedish females (HF) of the same age (Burström K et al 2006).MethodsEQ-5D is a generic health-related quality of life (HRQoL) instrument/questionnaire that is used for economic evaluations of health interventions. The EQ-5D measures HRQoL in five dimensions and three levels of response, and correlate with disease specific quality of life instruments like EORTC QLQ-C30. Using population derived weights, EQ5D responses are translated to a global index between 0 (death) and 1 (full health).Time-Trade-Off (TTO) is used in health economics to determine the quality of life by trading improved quality of life for reductions in survival time. The respondent can choose to live 10 or 20 years in current health state or choose to give up some life years to live for a shorter period in full health. The number of years she/he is willing to give up to gain full health is translated into an index between 0 (willing to give up all remaining life time) and 1 (not willing to give up any remaining life time).ResultsWe sent out these quality of life instruments to members of BRO. A total of 4900 (52%) responded out of which 4027 were free of relapse. Respondents had a mean age of 62.1 years. Tumor and treatment characteristics reflect the prevalent Swedish breast cancer population.EQ5D and TTO, mean (SE) in HF and breast cancer patients (BC) in relation to age.EQ5D&lt;40 y40-49 y50-59 y60-69 y70-79 y&gt;80 yHF0.859 (0.011)0.858 (0.012)0.833 (0.014)0.784 (0.017)0.792 (0.019)0.740 (0.033)BC0.759 (0.050)0.755 (0.050)0.804 (0.038)0.839 (0.035)0.852 (0.031)0.822 (0.038)TTO HF0.944 (0.009)0.944 (0.009)0.925 (0.010)0.894 (0.015)0.888 (0.017)0.673 (0.040)BC0.860 (0.037)0.883 (0.036)0.894 (0.036)0.909 (0.028)0.859 (0.046)0.769 (0.086) Mean EQ5D and TTO (SE) in relation to time since primary diagnosis and age (y) in BC patientsEQ5D&lt; 1 y1-3 y3-5 y&gt; 5 y&lt; 40 y0.714 (0.034)0.762 (0.043)0.703 (0.114)0.847 (0.019)40-49 y0.731 (0.043)0.734 (0.051)0.735 (0.060)0.800 (0.043)50-59 y0.779 (0.045)0.781 (0.035)0.789 (0.047)0.825 (0.035)60-69 y0.798 (0.048 )0.823 (0.034)0.837 (0.030)0.846 (0.036)70-79 y0.828 (0.020)0.846 (0.036)0.805 (0.056)0.860 (0.027)≥ 80 y-0.875 (0.021)0.662 (0.088)0.828 (0.036)TTO &lt; 40 y0.839 (0.028)0.855 (0.040)0.814 (0.050)0.945 (0.025)40-49 y0.884 (0.021)0.862 (0.040)0.894 (0.035)0.898 (0.035)50-59 y0.896 (0.028)0.897 ( 0.032)0.876 (0.041)0.901 (0.035)60-69 y0.922 (0.021)0.902 (0.029)0.911 (0.027)0.909 (0.028)70-79 ≥ 80 y-0.850 (0.078)0.636 (0.086)0.771 (0.087) Conclusions:The results of this study indicate that older (&gt;60y) women with BC have better health status (measured by EQ5D and TTO), than healthy females (HF). Younger women (&lt;60y) with BC have lower health status than HF, but it increases with time from diagnosis.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5047.