Is EQ-5D-5L sensitive enough to detect treatment-related changes in health status of prostate cancer patients? A nationwide Norwegian longitudinal study from the prostate cancer registry.

PURPOSE: To examine the generic European Quality of Life 5-Dimensions questionnaire (EQ-5D-5L) responsiveness to change in health status of patients with invasive prostate cancer (PCa) from pre- to post-treatment and compare these results with the responsiveness of disease-specific instruments assumed to be particularly sensitive to change in a large sample of PCa patients. METHODS: In this nationwide registry study (2017–2019), PCa patients in Norway (n = 620) and a matched reference group from the general population without previous cancer history (n = 1776) were invited. All participants completed the EQ-5D-5L, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and the Expanded Prostate Cancer Index Composite short form (EPIC-26) pre- and post-treatment. Paired t-tests were performed with latent change scores in a structural equation model framework. RESULTS: EQ-5D-5L showed minor changes from pre- to post-treatment for four dimensions and sum score (Cohen’s d ≤ 0.20). EORTC-QLQ-C30 revealed a moderate decline in social function (-9.85, p < 0.001, Cohen’s d -0.52). EPIC-26 showed a large decline in sexual function (-38.1, p < 0.001, Cohen’s d -1.42), and urine incontinency (-24.3, p < 0.001, Cohen’s d -1.86). Correlations between change in EQ-5D-5L and change in domains found to be important for participants with PCa (sexual function, urine incontinence and social function) revealed small to medium correlations for the PCa group. CONCLUSIONS: The low responsiveness indicates that the EQ-5D-5L is not sensitive enough in detecting health status changes due to significant problem areas in PCa patients. Adding disease-specific measures is pivotal to measuring these changes in health status.