OUTCOME STATES OF COLORECTAL-CANCER - IDENTIFICATION AND DESCRIPTION USING PATIENT FOCUS GROUPS

Objective: Utilities for the outcome states of colorectal cancer must be measured to evaluate the cost-utility of screening and surveillance strategies for this disease, We sought to identify these outcome stat es, define their associated areas of morbidity, and construct represen tative descriptions of them for use in a utilities assessment instrume nt, Methods: We identified candidate colorectal cancer outcome states based on a review of the literature and interviews with health care pr ofessionals. We organized patient focus groups from each of the candid ate outcome states to examine their homogeneity and define their assoc iated areas of morbidity, After analyzing the focus group transcripts, we identified and described outcome states of colorectal cancer for f uture incorporation into a utilities assessment instrument. Results: S ix candidate outcome states of cotorectal cancer were identified based on disease stage and location at diagnosis. Thirty-eight patients the n participated in six focus groups. Analysis of the focus group transc ripts revealed seven areas of morbidity associated with colorectal can cer. These areas included problems with social interaction and cogniti on, fear of cancer recurrence, pain, fatigue, changes in bowel habits, and sexual dysfunction, Based on differences in the intensity and fre quency of the symptoms reported in each of these areas, seven distinct outcome states of colorectal cancer were identified and described. Co nclusion: Clinically distinct outcome states of colorectal cancer are determined by the stage and location of the cancer at the time of diag nosis, Descriptions of these outcome states were created using data co llected from patient focus groups. These descriptions can be incorpora ted into a utilities assessment instrument. (Am J Gastroenterol 1998;9 3:1491-1497, (C) 1998 by Am, Cell. of Gastroenterology).