Quality of Life Research

, Volume 17, Issue 3, pp 437–445 | Cite as

Validation of the French version of the colorectal-specific quality-of-life questionnaires EORTC QLQ-CR38 and FACT-C

  • Christine  Rotonda
  • T. Conroy
  • M. Mercier
  • F. Bonnetain
  • L. Uwer
  • J. Miny
  • P. Montcuquet
  • I. Léonard
  • A. Adenis
  • G. Breysacher
  • F. Guillemin



The aim of this study was to test the psychometric properties of the French version of the European Organization for Research and Treatment (EORTC) quality-of-life colorectal questionnaire (QLQ-CR38) and the functional assessment of cancer therapy-colorectal version 4 (FACT-C).


This prospective study included 209 patients with colorectal cancer: 71 undergoing chemotherapy, 56 radiation, 15 surgery, and 67 survivors. Patients first completed in random order the FACT-C and the EORTC QLQ-CR38 and were asked if they had any preference for either questionnaire. The timing of administration of instruments differed according to patients’ treatment to better assess psychometric properties.


The FACT-C showed good acceptability, good reproducibility and excellent internal consistency. The QLQ-CR38 had lower internal consistency. Patients did not express a preference for one survey over another.


This study confirms the value of the FACT-C and suggests some limits of the QLQ-CR38 for patients with colorectal cancer.


Colorectal cancer Quality of life Validation EORTC QLQ-CR38 FACT-C 



Colorectal cancer subscale


Colorectal cancer


European Organization for Research and Treatment


Functional assessment of cancer therapy-colorectal


Functional assessment of cancer therapy-general


Global health status


Intraclass correlation coefficient


Karnofsky performance status


Quality-of-life colorectal questionnaire


Quality of life


Trial outcome index of FACT-C



We gratefully acknowledge J. Blazeby, C. Carnin, P. Bataillard, E. Petit, and E Lesieu for assistance with patient interviews and the physicians M.C. Kaminsky, P. Rauch, D. Peiffert, G. Créhange, P. Maingon, G. Truc, J. Fraisse, J. Cuisenier, B. Chauffert, E. Désandes, and J.M. Tortuyaux who helped recruit patients. We also thank Sonya Eremenco, Evanston, Illinois, for permission to use the FACT-C, and the EORTC QoL Group, Brussels, for permission to use the EORTC QLQ-C30 and QLQ-CR38 questionnaires. This study was supported by grants from the French Ministry of Health Clinical Research Hospital Program (PHRC 2004) and the cancéropole Grand-Est.


  1. 1.
    Ferlay, J., et al. (2007). Estimates of the cancer incidence and mortality in Europe in 2006. Annals of Oncology, 18, 581–592.PubMedCrossRefGoogle Scholar
  2. 2.
    Aaronson, N. K., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.PubMedCrossRefGoogle Scholar
  3. 3.
    Cella, D. F., et al. (1993). The Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570–579.PubMedGoogle Scholar
  4. 4.
    Conroy, T., et al. (2004). French version of FACT-G: Validation and comparison with other cancer-specific instruments. European Journal of Cancer, 40, 2243–2252.PubMedCrossRefGoogle Scholar
  5. 5.
    Rodary, C., et al. (2004). Patient preference for either the EORTC QLQ-C30 or the FACIT Quality Of Life (QOL) measures: A study performed in patients suffering from carcinoma of an unknown primary site (CUP). European Journal of Cancer, 40, 521–528.PubMedCrossRefGoogle Scholar
  6. 6.
    Costet, N., et al. (2005). Reliability and validity of the Functional Assessment of Cancer Therapy General (FACT-G) in French cancer patients. Quality of Life Research, 14, 1427–1432.PubMedCrossRefGoogle Scholar
  7. 7.
    Sprangers, M. A., et al. (1999). The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life. European Journal of Cancer, 35, 238–247.PubMedCrossRefGoogle Scholar
  8. 8.
    Ward, W. L., et al. (1999). Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality of life instrument. Quality of Life Research, 8, 181–195.PubMedCrossRefGoogle Scholar
  9. 9.
    Lucas, C. P. (1992). The order effect: Reflections on the validity of multiple test presentations. Psychological Medicine, 22, 197–202.PubMedCrossRefGoogle Scholar
  10. 10.
    Cull, A., et al. (1994). EORTC Quality of Life Study Group Translation Procedure. Brussels: European Organization for Research and Treatment of Cancer.Google Scholar
  11. 11.
    Lent, L., et al. (1999). Using cross-cultural input to adapt the Functional Assessment of Chronic Illness Therapy (FACIT) scales. Acta Oncologica, 38, 695–702.PubMedCrossRefGoogle Scholar
  12. 12.
    Cella, D. (1997). Manual of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement Syste. Version 4. Evanston IL: Center on Outcomes, Research & Education (CORE), Evanston Northwestern Healthcare and Northwestern University.Google Scholar
  13. 13.
    Fayers, P., et al. (2001). The EORTC QLQ-C30 Scoring Manual (3rd ed.). Brussels: European Organization for Research and Treatment of Cancer.Google Scholar
  14. 14.
    Landis, J. R., & Koch, G. G. (1977) The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.PubMedCrossRefGoogle Scholar
  15. 15.
    Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.CrossRefGoogle Scholar
  16. 16.
    Camilleri-Brennan, J., & Steele, R.J. (2001) The impact of recurrent rectal cancer on quality of life. European Journal of Surgical Oncology, 27, 349–353.PubMedCrossRefGoogle Scholar
  17. 17.
    Allal, A. S., et al. (2005). Assessment of quality of life in patients with rectal cancer treated by preoperative radiotherapy: a longitudinal prospective study. International Journal of Radiation Oncology, Biology, Physics, 61, 1129–1135.PubMedGoogle Scholar
  18. 18.
    Rauch, P., et al. (2004). Quality of life among disease-free survivors of rectal cancer. Journal of Clinical Oncology, 22, 354–360.PubMedCrossRefGoogle Scholar
  19. 19.
    Guren, M. G., et al. (2005). Quality of life and functional outcome following anterior or abdominoperineal resection for rectal cancer. European Journal of Surgical Oncology, 31, 735–742.PubMedCrossRefGoogle Scholar
  20. 20.
    Tjandra, J. J., et al. (2001). Phase II clinical trial of preoperative combined chemoradiation for T3 and T4 resectable rectal cancer: Preliminary results. Diseases of the Colon and Rectum, 44, 1113–1122.PubMedCrossRefGoogle Scholar
  21. 21.
    Camilleri-Brennan, J., & Steele, R. J. (2002). Objective assessment of morbidity and quality of life after surgery for low rectal cancer. Colorectal Disease, 4, 61–66.PubMedCrossRefGoogle Scholar
  22. 22.
    Gujral, S., et al. (2007). Assessing quality of life in patients with colorectal cancer: An update of the EORTC quality of life questionnaire. European Journal of Cancer, 43, 1564–1573.PubMedCrossRefGoogle Scholar
  23. 23.
    Blazeby, J. M., et al. (2004). Clinical and psychometric validation of a questionnaire module, the EORTC QLQ-STO 22, to assess quality of life in patients with gastric cancer. European Journal of Cancer, 40, 2260–2268.PubMedCrossRefGoogle Scholar
  24. 24.
    Yoo, H. J., et al. (2005). Quality of life in colorectal cancer patients with colectomy and the validation of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C), Version 4. Journal of Pain and Symptom Management, 30, 24–32.PubMedCrossRefGoogle Scholar
  25. 25.
    Tsunoda, A., et al. (2007). Validation of the Japanese version of EORTC QLQ-CR38. Quality of Life Research [Epub ahead of print].Google Scholar
  26. 26.
    Kavadas, V., et al. (2003). Development of an EORTC disease-specific quality of life questionnaire for use in patients with liver metastases from colorectal cancer. European Journal of Cancer, 39, 1259–1263.PubMedCrossRefGoogle Scholar
  27. 27.
    Yost, K. J., et al. (2005). Minimally important differences were estimated for the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) instrument using a combination of distribution- and anchor-based approaches. Journal of Clinical Epidemiology, 58, 1241–1251.PubMedCrossRefGoogle Scholar
  28. 28.
    Anthony, T., et al. (2003). The association of pretreatment health-related quality of life with surgical complications for patients undergoing open surgical resection for colorectal cancer. Annals of Surgery, 238, 690–696.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Christine  Rotonda
    • 1
  • T. Conroy
    • 1
    • 2
  • M. Mercier
    • 3
  • F. Bonnetain
    • 4
  • L. Uwer
    • 2
  • J. Miny
    • 5
  • P. Montcuquet
    • 5
  • I. Léonard
    • 1
    • 2
  • A. Adenis
    • 6
  • G. Breysacher
    • 7
  • F. Guillemin
    • 1
  1. 1.Nancy-University, EA 4003Vandoeuvre-les-NancyFrance
  2. 2.Department of Medical OncologyCentre Alexis VautrinVandoeuvre-les-NancyFrance
  3. 3.Medical and Pharmaceutical University, EA 2276BesanconFrance
  4. 4.Biostatistic and Epidemiological UnitCentre Georges-Francois LeclercDijonFrance
  5. 5.Department of Radiation OncologyUniversity hospital Jean MinjozBesanconFrance
  6. 6.Department of Digestive and Urologic OncologyCentre Oscar LambretLilleFrance
  7. 7.Department of HepatogastroenterologyHospital Louis PasteurColmarFrance

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