A comparison of ovarian cancer treatments: analysis of utility assessments of ovarian cancer patients, at-risk population, general population, and physicians.

OBJECTIVES

Perceptions of the severity of chemotherapy-related toxicity differ among physicians, ovarian cancer patients, at-risk individuals, and persons in the general population. In this study, we elicited assessments of toxicity from women with ovarian cancer, women at increased risk of developing ovarian cancer, women in the general population, and gynecologic oncologists.

METHODS

Thirty-nine ovarian cancer patients, fifteen women at increased risk, thirty-nine women at baseline risk, and eleven gynecologic oncologists completed utility assessment surveys.

RESULTS

There was good face validity to the utility exercise as assessments of health states. Health states with toxicity were consistently associated with less favorable assessments than the health states with no toxicity. The ovarian cancer patients as a group and the women at risk for the development of ovarian cancer viewed health states with toxicity similarly and more favorably than women in the general population. However, patient assessments varied, with the most favorable assessment of life with toxicity being reported from individuals who had experienced such toxicity. Physician assessments of the impact of toxicity on overall health status were most similar to those obtained from patients who had experienced moderate to severe toxicity, and were more favorable than those elicited from patients who had not experienced any toxicity.

CONCLUSIONS

Assessments of the impact of chemotherapy-related toxicity vary depending on the perspective of the individual responding to these questions. In discussing ovarian cancer treatments with at-risk women and the general population, concerns over treatment-related toxicity are likely to be greater than those expressed by persons who are more familiar with the actual occurrence of such events and therapeutic preferences may be affected as a result.