RESUMO
BACKGROUND/OBJECTIVES: Keratinocyte cancer impacts health-related quality of life (HRQL). Disease progression and treatment can lead to adverse physical and psychosocial consequences. The skin cancer index (SCI) is a validated tool with higher scores reflecting greater HRQL. Our objectives were to assess and compare the impact of keratinocyte cancer using the SCI in two diverse populations. METHODS: A total of 120 patients were prospectively recruited from dermatology clinics in Sydney, Australia, and Santander, Spain, providing demographics and completing the SCI. RESULTS: About 61.1% of Australians reported ≥2 skin cancers (vs 20% P = <0.001), 44.4% resulting visible scars (vs 14.8% P = <0.001). Visible scars were associated with poorer HRQL, across total SCI (68.3 vs 81.5 P = <0.001), social (76.0 vs 86.7 P = 0.003) and emotional (54.2 vs 69.7 P = 0.003) domains. Interestingly, perceived visible scars were not associated with appearance scores. The Spanish population reported greater appearance (88.0 vs 75.6 P = 0.008) and emotional (70.7 vs 60.5 P = 0.034) HRQL. Surprisingly, incidence of cancer, recent disease, gender and education were not associated with HRQL impairment. CONCLUSIONS: Australians with keratinocyte cancer experience poorer HRQL compared to a Spanish population. Offering non-surgical means when amenable and consideration of psychosocial needs during clinical course is emphasised. While our study highlights the importance of HRQL tools, our results question the sensitivity of the SCI across populations. Further research is required to substantiate its ongoing use.