Health-Related Quality of Life Associated with Barrett’s Esophagus and Cancer

  • Norma B. Bulamu
  • Gang ChenEmail author
  • Julie Ratcliffe
  • Ann Schloite
  • Tim Bright
  • David I. Watson
Original Scientific Report



Research assessing health-related quality of life (HRQoL) which can be applied to economic evaluation in Barrett’s esophagus (BE) and esophageal cancer is limited. This study derived health state utilities for various ‘stages’ of BE and Cancer.


A cross-sectional survey was conducted, including patients with non-dysplastic BE, low-grade dysplasia, high-grade dysplasia, or esophageal adenocarcinoma. HRQoL was assessed using generic instruments—EQ-5D-5L and SF-36, and a cancer-specific instrument—EORTC QLQ-C30. Outcomes were compared for health states following different treatments. Correlations and agreements for the three instruments were investigated using Spearman’s correlation coefficient (r) and intraclass correlation coefficient (ICC).


A total of 97 respondents (80% male, mean age 68 years) returned questionnaires. The mean (standard deviation) health state utilities for the total sample were 0.79 (0.24) for the EQ-5D-5L, 0.57 (0.29) for the SF-6D (derived from SF-36) and 0.73 (0.20) for the QLU-C10D (derived from EORTC QLQ-C30). There were strong correlations (r > 0.80) and absolute agreement (except EQ-5D-5L and SF-6D with an ICC of 0.69) among the three instruments. No significant differences were observed for different stages of BE or interventions. However, following surgery for cancer patients reported better psychological well-being than those under surveillance or following endoscopic treatments.


HRQoL for BE surveillance and following cancer treatment was similar. Esophagectomy was associated with better psychological functioning, and this might be attributed to a reduction in the perceived risk of cancer. The correlation between the EORTC QLU-C10D and the other health state utility instruments supports the validity of this new instrument.



The authors would like to thank Jeff Bull, Tanya Irvine, and George Mayne for their support.


Professors Watson and Ratcliffe received a Beat Cancer Hospital Research Package Grant which was funded by the Cancer Council of South Australia’s Beat Cancer Project on behalf of its donors and the State Government of South Australia Department of Health, together with the support of the Flinders Medical Centre Foundation, its donors and partners. This Grant funded Dr. Norma B. Bulamu’s and Dr. Gang Chen’s salary.

Compliance with ethical standards

Conflict of interest

There are no competing interests or conflicts of interests to disclose among the authors.


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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  1. 1.Flinders Centre for Innovation in Cancer, College of Medicine and Public HealthFlinders UniversityAdelaideAustralia
  2. 2.Centre for Health Economics, Monash Business SchoolMonash UniversityMelbourneAustralia
  3. 3.Institute of Choice, Business SchoolUniversity of South AustraliaAdelaideAustralia
  4. 4.Discipline of Surgery, College of Medicine and Public HealthFlinders UniversityAdelaideAustralia

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