BASE-LINE AND POSTTREATMENT ASSESSMENT OF THE GENERAL HEALTH-STATUS OF HEAD AND NECK-CANCER PATIENTS COMPARED WITH UNITED-STATES POPULATIONNORMS

Background. It is a common perception that the overall health of patie nts with head and neck cancer (HNC) is likely to be poor compared with the general population. This project was undertaken to investigate th e pre-and post-treatment, global health status of HNC patients in comp arison with age-matched, U.S. population norms using a self-administer ed general health status survey. Methods. Between July 1, 1993, and Ma y 1, 1996, 180 patients underwent pretreatment and 6 month follow-up e valuation with the standard version of the Medical Outcomes Study 36-I tem Short-Form Health Survey (SF-36). The SF-36 scale scores, means, s tandard deviations, and 95% confidence intervals were calculated for e ach SF-36 scale as well as for physical-health-component summary score s (PCS) and mental-health component summary scores (MCS). Comparisons of these scores were made to U.S. population normative data. Pretreatm ent and 6-month follow-up SF-36 scores were compared. Results. In the 45-54-year age group, all 8 SF-36 scale scores, the PCS, and MCS score s were significantly worse for the HNC patients in comparison with age -matched norms (p < .05). In the 55-64-year age group, the HNC patient s were worse in 5 of the 8 SF-36 scale scores and the MCS score in com parison with age-matched norms (p < .05), In the 65-74-year age group, the HNC patients scored significantly worse in the mental health scal e. In the comparison of pretreatment and 6-month follow-up scores, the HNC patients had significant decreases in the physical functioning sc ale (p = .003) and the PCS score (p = .047). The HNC patients showed s ignificant improvement in the mental health scale (p = .049) and impro vement in the bodily-pain scale, which approached significance (p = .0 53) at 6-month follow-up. The HNC patients showed a marked decrease in general health status with increasing stage of HNC. Conclusions. This work provides objective support for the perception that many HNC pati ents are initially seen for treatment with baseline health status func tioning significantly below their age-matched contemporaries in the ge neral population. An educated evaluation of global health outcomes fol lowing treatment in the HNC patient population must begin with an accu rate pretreatment assessment of these parameters. Self-reported health status assessment (HSA) is a useful means of evaluating global health status in this patient population. (C) 1997 John Wiley & Sons, Inc.