Quality of Life Research

, Volume 23, Issue 2, pp 385–391 | Cite as

Associations of cancer and other chronic medical conditions with SF-6D preference-based scores in Medicare beneficiaries

  • Ron D. Hays
  • Bryce B. Reeve
  • Ashley Wilder Smith
  • Steven B. Clauser



Documenting the impact of different types of cancer on daily functioning and well-being is important for understanding burden relative to other chronic medical conditions. This study examined the impact of 10 different cancers and 13 other chronic medical conditions on health-related quality of life.


Health-related quality of life data were gathered on the Medicare Health Outcomes Survey (MHOS) between 1998 and 2002. Cancer information was ascertained using the National Cancer Institute’s surveillance, epidemiology, and end results program and linked to MHOS data.


The average SF-6D score was 0.73 (SD = 0.14). Depressive symptoms had the largest unique association with the SF-6D, followed by arthritis of the hip, chronic obstructive pulmonary disease/asthma, stroke, and sciatica. In addition, the majority of cancer types were significantly associated with the SF-6D score, with significant negative weights ranging from −0.01 to −0.02 on the 0–1 health utility scale. Distant stage of cancer was associated with large decrements in the SF-6D ranging from −0.04 (prostate) to −0.08 (female breast).


A large number of chronic conditions, including cancer, are associated uniquely with decrements in health utility. The cumulative effects of comorbid conditions have substantial impact on daily functioning and well-being of Medicare beneficiaries.


Cancer and comorbidity Health-related quality of life Preference-based measures Utilities 



This project was supported by NCI internal funds. Dr. Hays was also supported in part by grants from NIA (P30AG021684) and the NIMHD (2P20MD000182). The SEER-MHOS linked data set is now in the public domain. More information about the data set is available at For questions, technical support is available at


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Ron D. Hays
    • 1
  • Bryce B. Reeve
    • 2
  • Ashley Wilder Smith
    • 3
  • Steven B. Clauser
    • 3
  1. 1.Division of General Internal Medicine & Health Services ResearchDavid Geffen School of Medicine at UCLALos AngelesUSA
  2. 2.Lineberger Comprehensive Cancer Center, Department of Health Policy and ManagementGillings School of Global Public Health, University of North CarolinaChapel HillUSA
  3. 3.National Cancer InstituteBethesdaUSA

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