J Gastrointestin Liver Dis, December 2014 Vol. 23 No 4: 371-378 1) Center for Research in Health Technologies and Information Systems, Faculty of Medicine, Porto University; 2) Gastroenterology Dept., Portuguese Oncology Institute of Coimbra; 3) Gastroenterology Dept., Portuguese Oncology Institute of Lisbon; 4) Gastroenterology Dept., Santa Luzia Hospital - Viana do Castelo (Local Health Unit of Alto Minho); 5) Gastroenterology Dept., Santo António General Hospital, Hospital Centre of Porto; 6) Institute of Biomedical Sciences Abel Salazar,University of Porto; 7) Gastroenterology Dept., Hospital Unit of Portimão (Hospital Center of Western Algarve); 8) Gastroenterology Dept., Coimbra University Hospital Center; 9) Gastroenterology Dept., Portuguese Oncology Institute of Porto; 10) Gastroenterology Dept., West Lisbon Hospital Centre, Lisbon, Portugal Address for correspondence: Miguel Areia Gastroenterology Department Portuguese Oncology Institute Coimbra, Portugal miguel.areia75@gmail.com Received: 25.07.2014 Accepted: 08.09.2014 Health-related Quality of Life and Utilities in Gastric Premalignant Conditions and Malignant Lesions: a Multicentre Study in a High Prevalence Country Miguel Areia 1,2 , Susana Alves 2 , Daniel Brito 2 , Ana Teresa Cadime 2 , Rita Carvalho 2 , Sandra Saraiva 2 , Sara Ferreira 3 , Joana Moleiro 3 , António Dias Pereira 3 , João Carrasquinho 4 , Luís Lopes 4 , José Ramada 4 , Ricardo Marcos-Pinto 1,5,6 , Isabel Pedroto 5,6 , Luís Contente 7 , Liliana Eliseu 7 , Ana Margarida Vieira 7 , Margarida Sampaio 7 , Helena Tavares Sousa 7 , Nuno Almeida 8 , Carlos Gregório 8 , Francisco Portela 8 , Carlos Sofia 8 , Vânia Braga 9 , Elisabete Baginha 10 , Tiago Bana e Costa 10 , Cristina Chagas 10 , Luís Lebre Mendes 10 , Pedro Magalhães-Costa 10 , Leopoldo Matos 10 , Francisco Rocha Gonçalves 1,9 , Mário Dinis-Ribeiro 1,9 INTRODUCTION Gastric adenocarcinoma is a health problem worldwide due to its high incidence and mortality rates, being the fourth most common malignancy and the second leading cause of cancer death [1]. Its prognosis is highly dependent on the stage at diagnosis but usually presents at an advanced stage requiring demanding treatments and costs ORIGINAL PAPER ABSTRACT Background & Aims: A recent review of economic studies relating to gastric cancer revealed that authors use different tests to estimate utilities in patients with and without gastric cancer. Our aim was to determine the utilities of gastric premalignant conditions and adenocarcinoma with a single standardized health measure instrument. Methods: Cross-sectional nationwide study of patients undergoing upper endoscopy (n=1,434) using the EQ-5D-5L quality of life (QoL) questionnaire. Results: According to EQ-5D-5L, utilities in individuals without gastric lesions were 0.78 (95% confidence interval: 0.76-0.80), with gastric premalignant conditions 0.79 (0.77-0.81), previously treated for gastric cancer 0.77 (0.73-0.81) and with present cancer 0.68 (0.55-0.81). Self-reported QoL according to the visual analogue scale (VAS) for the same groups were 0.67 (0.66-0.69), 0.67 (0.66-0.69), 0.62 (0.59-0.65) and 0.62 (0.54-0.70) respectively. Utilities were consistently lower in women versus men (no lesions 0.71 vs. 0.78; premalignant conditions 0.70 vs. 0.82; treated for cancer 0.72 vs. 0.78 and present cancer 0.66 vs. 0.70). Conclusion: e health-related QoL utilities of patients with premalignant conditions are similar to those without gastric diseases whereas patients with present cancer show decreased utilities. Moreover, women had consistently lower utilities than men. ese results confirm that the use of a single standardized instrument such as the EQ-5D-5L for all stages of the gastric carcinogenesis cascade is feasible and that it captures differences between conditions and gender dissimilarities, being relevant information for authors pretending to conduct further cost-utility analysis. Key words: gastrointestinal endoscopy − QoL − gastric cancer − intestinal metaplasia − atrophic gastritis. Abbreviations: LYS: life-years saved; QALY: quality-adjusted life years; VAS: visual analogue scale; CI: confidence interval. Available from: URL: http://www.jgld.ro/2014/4/7 DOI: http://dx.doi.org/10.15403/jgld.2014.1121.234.hrq and impairing quality of life (QoL), even for patients with a good prognosis [2]. In health economics studies, the clinical strategies adopted for a problem such as gastric cancer are compared by simultaneously addressing their differences in terms of both clinical benefits and the cost of achieving them [3]. Guidelines recommend conducting cost-utility analysis where the use of clinical benefits should be adjusted to patient preferences. us, life-years saved (LYS) may be adjusted to utilities in terms of QoL, quality adjusted life years (QALYs), meaning that 1 year of life is multiplied by a utility factor between 1 and 0, providing different values for each single year of life, resulting in an utility value that will vary between 1 QALY (one year with perfect