The idea that older people might interpret the term 'quality of life' differently to their younger counterparts would seem to be intuitive. To date, however, there has been no tool with which to specifically evaluate the health-related quality of life of elderly patients with cancer.

During a literature review, Colin Johnson et al. found “no elderly-specific tool, and no evidence that more general tools had been validated in older people.” This prompted development of the European Organisation for Research and Treatment of Cancer quality of life questionnaire module for older people with cancer (or EORTC QLQ-ELD15).

The first challenge for the researchers was defining 'older people'. The team concluded that this term should encompass patients aged 70 years or more. They then matched members of their older cohort—on the basis of cancer stage and type (including prostate cancer)—with patients aged between 50 and 69 years, to ensure that the quality-of-life issues identified were age-specific.

A list of 75 health-related quality-of-life issues was generated from literature review, and from interviews with patients and caregivers. Condensed to a shortlist of 45, these issues were allocated to one of five categories; mobility, family support, concerns about the future, autonomy and independence, and burden of illness. Issue-specific questions were then generated, and translated into the relevant languages for assessment by patients in the UK, Spain, Sweden, France, Belgium, Turkey and Canada.

After 97 patients aged 70 years or over and 85 patients aged 50–69 years had completed the questionnaire and attended a debrief interview, the researchers identified 15 issues that were of particular importance to older people. These have been developed into the EORTC QLQ-ELD15, which is now ready for validation.

“We feel that [we have] produced a health-related quality-of-life measure that covers the widest possible range of issues of concern, with as few questions as possible” conclude the authors.