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John S. Rhee, MD, MPH; B. Alex Matthews, PhD; Marcy Neuburg, MD; Timothy L. Smith, MD, MPH; Mary Burzynski, RN; Ann B. Nattinger, MD, MPH

Arch Otolaryngol Head Neck Surg. 2004;130:141-146.

Objectives  To determine whether change occurred in the general quality of life (QOL) of nonmelanoma skin cancer (NMSC) patients following surgery, to identify variables associated with patients' change in QOL, and to assess the impact of the disease and treatment on sun-protective behaviors and cigarette smoking.

Design  Longitudinal prospective study of 121 consecutive patients referred to a dermatologic Mohs surgery clinic with NMSC of the head and neck.

Interventions  Quality-of-life, smoking habit, and sun-protective behavior assessments were performed before treatment (N = 121) and after surgical treatment at 1 (n = 105) and 4 (n = 101) months. Quality-of-life measures included the Medical Outcomes Study 36-Item Short-Form Health Survey and the Functional Assessment of Cancer Therapy–General.

Results  Overall, general QOL measures demonstrated little change over time. Only the mental (Medical Outcomes Study 36-Item Short-Form Health Survey) and emotional (Functional Assessment of Cancer Therapy–General) domains of QOL showed statistically significant change over time. A 2-way interaction showing effects for age and time on emotional well-being was modified by a 3-way interaction that depended on employment status. Emotional well-being scores for younger employed NMSC patients increased over time compared with scores among younger unemployed patients. In addition, many patients adopted greater use of sun-protective behaviors at 4 months following surgery. No change in cigarette smoking status was evidenced.

Conclusions  Use of sun-protective behaviors increases after treatment. General QOL instruments demonstrate little change following treatment of NMSC. Although the associations are modest, improvements in emotional and mental health well-being following treatment of NMSC were demonstrated, especially for those younger than 65 years and employed. A disease-specific instrument may be necessary to further study this disease process.

From the Departments of Otolaryngology and Communication Sciences (Drs Rhee and Smith and Ms Burzynski) and Dermatology (Dr Neuburg) and the Health Policy Institute, Center for Patient Care and Outcomes Research (Drs Matthews and Nattinger), Medical College of Wisconsin, Milwaukee. The authors have no relevant financial interest in this article.

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