Quality of life issues faced by patients with keratinocyte cancer: A systematic review

Introduction Keratinocyte carcinomas (KC), including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), represent the most prevalent malignancy worldwide with a rapidly increasing incidence. While KC and its treatment can negatively impact patients quality of life (QoL), existing QoL instruments lack specificity for unique KC-related issues. This systematic review explores the relevant QoL issues pertinent to patients with KC. Methods Literature from Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases from 1946 to January 2023 was systematically reviewed. Two independent reviewers screened and extracted studies of all designs discussing KC-specific QoL issues. Results The systematic review identified prevalent QoL issues in the literature. Some generic QoL-related issues are covered by more general cancer QoL instruments that are not site specific to KC, such as the EORTC QLQ-C30. These include pain, functioning, daily activities, work, leisure time, and social and family relationships. More KC-specific issues include the impact of cosmetic outcomes on QoL, such as scarring, skin pigmentation change, embarrassment, distress, and social withdrawal. Improved sun awareness, including increased sunscreen use, avoidance of outdoor activities, and sun-protective clothing usage, emerged as common changes in behavior. These issues may result from both the disease and the treatment. Conclusions This review has identified multiple KC-specific QoL issues, highlighting need for a tailored QoL instrument to measure these KC-specific issues. As the landscape of KC research and treatment modalities evolve, a gap persists in terms of a standardized QoL measurement for both clinical and research contexts. A new QoL instrument needs to be developed which is better tailored to the needs of patients with KC.