QUALITY OF LIFE VERSUS LENGTH OF LIFE: PREFERENCES OF CANCER PATIENTS FROM EIGHT EUROPEAN COUNTRIES
Author(s)
Lára Hallsson, BSc, MPH, PhD1, Negin Esfandiari, DVM1, Lennart Koch, MPH1, Yassin Engelberts, MSc2, Sheila Payne, Prof3, Kasper Frank, BSc4, Lea Doppelbauer, MD5, Barbara Peric, MD6, Elham Hedayati, MD7, Ida Korfage, Prof2, Uwe Siebert, MPH, MSc, ScD8, Gaby Sroczynski, MPH, DrPH1.
1UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 2Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands, 3Lancaster University, Lancaster, United Kingdom, 4University of Southern Denmark, Vejle, Denmark, 5Charité Universitätsmedizin Berlin, Berlin, Germany, 6Institute of Oncology Ljubljana, Ljubljana, Slovenia, 7Karolinska Institute, Stockholm, Sweden, 8UMIT TIROL - University for Health Sciences and Technology; Harvard Chan School of Public Health, Hall in Tirol, Austria.
1UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 2Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands, 3Lancaster University, Lancaster, United Kingdom, 4University of Southern Denmark, Vejle, Denmark, 5Charité Universitätsmedizin Berlin, Berlin, Germany, 6Institute of Oncology Ljubljana, Ljubljana, Slovenia, 7Karolinska Institute, Stockholm, Sweden, 8UMIT TIROL - University for Health Sciences and Technology; Harvard Chan School of Public Health, Hall in Tirol, Austria.
OBJECTIVES: Shared decision-making combines patients’ values, goals, and preferences with physicians’ medical expertise. Evidence on cancer patients’ attitude towards treatment, particularly whether they prioritize quality of life (QoL) over length of life (LoL), remains limited. This study aimed to assess patients’ preference toward QoL versus LoL.
METHODS: Within the 4D PICTURE project, patients diagnosed with cancer from eight European countries (Austria, Denmark, Germany, the Netherlands, Slovenia, Spain, Sweden, and UK) completed a digital questionnaire. Using a 5-point Likert scale, patients indicated whether they considered QoL more important than LoL. Additionally, demographic and clinical data were collected, including age, sex, marital status, cancer type, treatment type, and time since diagnosis. Responses were analyzed descriptively and with mixed-effects ordinal regression including country as a random factor. Sensitivity analyses using subgroup interaction models were conducted to assess the robustness and generalizability of the findings. Outcomes are reported as odds ratios (OR) with 95% confidence intervals (95% CI).
RESULTS: Among patients with cancer (n = 2,284; 71.4% women; mean age 59.7 ± 12.1 years), 61.4% reported that QoL was more important than LoL. Preferences for QoL over LoL varied across countries. After adjustment for demographic, clinical, and cross-country heterogeneity, older age (per 10 years increase) (OR = 1.15, 95% CI 1.10 - 1.21, p<0.01), having treatment completed (OR = 1.17, 95% CI 1.00-1.37, p=0.04782), and certain cancer types, particularly brain/CNS (OR = 3.88, 95% CI 1.51 - 10.01, p<0.01) and lung/pleural cancers (OR = 1.48, 95% CI 1.03 - 2.14, p<0.01) were associated with higher odds of prioritizing QoL over LoL. Sensitivity analyses supported the robustness of the findings.
CONCLUSIONS: Across eight European countries, patients with cancer tend to place greater value on QoL than on LoL, emphasizing the importance of considering patients’ preferences for QoL in the shared decision-making process in oncology.
METHODS: Within the 4D PICTURE project, patients diagnosed with cancer from eight European countries (Austria, Denmark, Germany, the Netherlands, Slovenia, Spain, Sweden, and UK) completed a digital questionnaire. Using a 5-point Likert scale, patients indicated whether they considered QoL more important than LoL. Additionally, demographic and clinical data were collected, including age, sex, marital status, cancer type, treatment type, and time since diagnosis. Responses were analyzed descriptively and with mixed-effects ordinal regression including country as a random factor. Sensitivity analyses using subgroup interaction models were conducted to assess the robustness and generalizability of the findings. Outcomes are reported as odds ratios (OR) with 95% confidence intervals (95% CI).
RESULTS: Among patients with cancer (n = 2,284; 71.4% women; mean age 59.7 ± 12.1 years), 61.4% reported that QoL was more important than LoL. Preferences for QoL over LoL varied across countries. After adjustment for demographic, clinical, and cross-country heterogeneity, older age (per 10 years increase) (OR = 1.15, 95% CI 1.10 - 1.21, p<0.01), having treatment completed (OR = 1.17, 95% CI 1.00-1.37, p=0.04782), and certain cancer types, particularly brain/CNS (OR = 3.88, 95% CI 1.51 - 10.01, p<0.01) and lung/pleural cancers (OR = 1.48, 95% CI 1.03 - 2.14, p<0.01) were associated with higher odds of prioritizing QoL over LoL. Sensitivity analyses supported the robustness of the findings.
CONCLUSIONS: Across eight European countries, patients with cancer tend to place greater value on QoL than on LoL, emphasizing the importance of considering patients’ preferences for QoL in the shared decision-making process in oncology.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
P31
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Patient-Centered Research
Disease
Oncology