Severity of disease and quality of life: A comparison in patients with cancer and benign disease

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Abstract
The aim of our study was to compare the quality of life in patients with malignant and benign diseases. Eighty-nine females and 110 males (mean age 59 years) from the surgical unit at the University Hospital of Linköping were examined. Ninety-five subjects suffering from a gastrointestinal malignancy were compared with 104 non-malignant patients, of which 57 had benign gastrointestinal disorders, 24 endocrine and 23 vascular diseases. Quality of life was defined as perceived well-being and life satisfaction, globally as well as within key domains. Two separate types of self-ratings, a life domain (20 items) and a well-being rating (eleven subscales, each scale with ten items), were performed in the medical ward. The life domain rating covered the subject's own appraisal of his health and psychological circumstances; social network; activities and habits; of a structural domain (‘ability to lead a meaningful life’) and of his global life satisfaction. The well-being rating focused on emotional experiences (basic mood, security, indolence, loneliness, inferiority, and guilt together with future-orientation) and perceived behaviour (endurance, tension, sociability and attitudes of the environment). The patients who had a gastrointestinal malignancy scored consistently ‘lower’ than patients with benign diseases. After adjusting for age concerns, most of the significant inter-group differences remained. After adjusting for nutritional state influences (e.g., recent weight loss), differences in global life satisfaction, future-orientation and perceived attitude from the environment were still apparent. This study is contrary to several other studies undertaken in search of expected group differences but none were found. The reason for the difference may be that the assessment techniques used in those studies focused exclusively on negative experiences of life or symptoms, which are fairly insensitive as quality of life indicators.