Jeon Han Jo, Choi Hyuk Soon, Lee Jae Min, Kim Eun Sun, Keum Bora, Jeen Yoon Tae, Lee Hong Sik, Chun Hoon Jai, Jeong Yujin
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea.
J Gastroenterol Hepatol. 2025 Sep;40(9):2219-2230. doi: 10.1111/jgh.70000. Epub 2025 Aug 7.
This study evaluated the health-related quality of life (HRQoL) of Korean gastric cancer survivors (GCSs) aged ≥ 19 years using preference-based measurements with a converted health utility index.
Data from the fourth to eighth cycles of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2020 were analyzed. Propensity score matching (PSM) was performed to mitigate baseline covariate imbalances between the GCS group and the non-GCS group. The EuroQol (EQ)-5D-3L questionnaire and EQ-5D index were used to evaluate the HRQoL of five GCSs.
A total of 113 091 individuals participated in the screening program. PSM found the HRQoL of the GCS group (535; 16.67%) to be significantly lower than that of the non-GCS group (2675; 83.33%) (EQ-5D index: 0.904 vs. 0.917, p = 0.039). The EQ-5D index significantly decreased by 0.014 for every increase in the GCS score (p = 0.027, 95% CI -0.02 to -0.002). Patients with activity limitation had the highest probability of experiencing issues in performing usual activities (odds ratio 8.321; 95% CI 3.707-18.678). Participants with positive subjective health perceptions had a decreased likelihood of experiencing problems (odds ratio 0.149-0.406). Factors that influenced the EQ-5D index of GCSs included activity limitation, subjective health perception, age, and sex.
The matched cohort revealed that Korean GCSs had significantly lower HRQoL than the non-GCS population. To enhance the HRQoL of GCSs, alleviating activity limitations and improving subjective health perception simultaneously are paramount.
本研究使用转换后的健康效用指数，通过基于偏好的测量方法，评估了年龄≥19岁的韩国胃癌幸存者（GCSs）的健康相关生活质量（HRQoL）。
分析了2007年至2020年韩国国家健康与营养检查调查（KNHANES）第四至第八轮的数据。进行倾向得分匹配（PSM）以减轻GCS组和非GCS组之间的基线协变量不平衡。使用欧洲五维度健康量表（EQ）-5D-3L问卷和EQ-5D指数来评估5个GCSs的HRQoL。
共有113091人参与了筛查项目。PSM发现GCS组（535人；16.67%）的HRQoL显著低于非GCS组（2675人；83.33%）（EQ-5D指数：0.904对0.917，p = 0.039）。GCS得分每增加1分，EQ-5D指数显著下降0.014（p = 0.027，95%置信区间-0.02至-0.002）。活动受限的患者在进行日常活动时出现问题的概率最高（优势比8.321；95%置信区间3.707 - 18.678）。主观健康认知为积极的参与者出现问题的可能性降低（优势比0.149 - 0.406）。影响GCSs的EQ-5D指数的因素包括活动受限、主观健康认知、年龄和性别。
匹配队列显示，韩国GCSs的HRQoL显著低于非GCS人群。为提高GCSs的HRQoL，同时减轻活动受限和改善主观健康认知至关重要。
