Quality of Life and Health State Utilities in Bladder Cancer

Area of Science:

• Oncology
• Health Services Research
• Patient-Reported Outcomes

Background:

• Bladder cancer treatments can significantly impact patient health-related quality of life (QOL).
• Understanding QOL across the disease continuum is crucial for comprehensive patient care.
• Existing data may not fully capture QOL variations from early to advanced bladder cancer stages.

Purpose of the Study:

• To comprehensively assess the quality of life (QOL) in bladder cancer patients.
• To characterize QOL across different stages: non-muscle-invasive (NMIBC), muscle-invasive (MIBC), and metastatic bladder cancer.
• To develop health state utility scores for cost-effectiveness analyses in bladder cancer care.

Main Methods:

• Cross-sectional survey of 911 bladder cancer patients via the Bladder Cancer Advocacy Network Patient Survey Network.
• Classification of patients into NMIBC, MIBC, or metastatic health states.
• Utilized generalized linear mixed models to analyze QOL, financial toxicity, and work impairment data, deriving health state utilities.

Main Results:

• Overall QOL and functional domains worsened with advancing bladder cancer stage.
• Work and activity impairment increased significantly from NMIBC to metastatic disease (13%/12% to 63%/31%).
• Specific QOL deficits included bowel issues in MIBC and urinary/physical function in metastatic disease; emotional functioning was poorer in MIBC and metastatic groups.

Conclusions:

• Health-related quality of life (QOL) diminishes progressively with advancing bladder cancer.
• Derived health state utility scores provide valuable data for shared decision-making.
• These utility estimates can inform future economic evaluations and cost-effectiveness analyses in bladder cancer treatment.