Objectives

Cancer diagnoses at later stages are associated with a decrease in health-related quality of life (HRQOL). Health state utility values (HSUVs) reflect preference-based HRQOL and can vary based on cancer type, stage, treatment, and disease progression. Detecting and treating cancer at earlier stages may lead to improved HRQOL, which is important for value assessments. We describe published HSUVs by cancer type and stage.

Methods

A systematic review was conducted using Embase, MEDLINE^®, EconLit, and gray literature to identify studies published from January 1999 to September 2019 that reported HSUVs by cancer type and stage. Disutility values were calculated from differences in reported HSUVs across cancer stages.

Results

From 13,872 publications, 27 were eligible for evidence synthesis. The most frequent cancer types were breast (n = 9), lung (n = 5), colorectal (n = 4), and cervical cancer (n = 3). Mean HSUVs decreased with increased cancer stage, with consistently lower values seen in stage IV or later-stage cancer across studies (e.g., − 0.74, − 0.44, and − 0.51 for breast, colorectal, and cervical cancer, respectively). Disutility values were highest between later-stage (metastatic or stage IV) cancers compared to earlier-stage (localized or stage I–III) cancers.

Conclusions

This study provides a summary of HSUVs across different cancer types and stages that can inform economic evaluations. Despite the large variation in HSUVs overall, a consistent decline in HSUVs can be seen in the later stages, including stage IV. These findings indicate substantial impairment on individuals’ quality of life and suggest value in early detection and intervention.

中文翻译：

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癌症阶段的健康状态效用值：系统文献回顾

目标

晚期癌症诊断与健康相关生活质量 (HRQOL) 的下降有关。健康状态效用值 (HSUV) 反映了基于偏好的 HRQOL，并且可能因癌症类型、分期、治疗和疾病进展而异。在早期阶段检测和治疗癌症可能会改善 HRQOL，这对于价值评估很重要。我们按癌症类型和分期描述已发表的 HSUV。

方法

使用 Embase、MEDLINE®、EconLit 和灰色文献进行了系统评价，^以确定 1999 年 1 月至 2019 年 9 月发表的按癌症类型和分期报告 HSUV 的研究。负效用值是根据报告的不同癌症阶段的 HSUV 的差异计算得出的。

结果

在 13,872 份出版物中，有 27 份符合证据综合条件。最常见的癌症类型是乳腺癌（n  = 9）、肺癌（n  = 5）、结直肠癌（n  = 4）和宫颈癌（n  = 3）。平均 HSUVs 随着癌症分期的增加而降低，在所有研究中，IV 期或晚期癌症的值始终较低（例如，乳腺癌、结直肠癌和宫颈癌分别为 - 0.74、- 0.44 和 - 0.51）。与早期（局部或 I-III 期）癌症相比，晚期（转移性或 IV 期）癌症的负效用值最高。

结论

本研究总结了不同癌症类型和阶段的 HSUV，可为经济评估提供信息。尽管总体上 HSUV 的差异很大，但在包括 IV 期在内的后期可以看到 HSUV 的持续下降。这些发现表明对个人生活质量的严重损害，并表明早期发现和干预的价值。