Health-Related Quality of Life Among People Diagnosed with High-Risk Non-Muscle Invasive Bladder: Baseline Data from the ANZUP BCG + Mitomycin Clinical Trial

Abstract

Background/Objectives: Intravesical therapy is associated with a range of side effects. This study assessed baseline self-reported health-related quality of life (HRQoL) scores and examined associations with clinical and demographic variables, as well as lower urinary symptom severity and bother scores, among individuals diagnosed with high-risk non-muscle invasive bladder cancer (NMIBC) prior to initiating intravesical Bacillus Calmette–Guérin (BCG) therapy, either alone or in combination with Mitomycin. Methods: Baseline data were collected from 501 participants with high-risk NMIBC enrolled in the Australian and New Zealand Urogenital Clinical Trials Group (ANZUP) BCG + Mitomycin Clinical Trial, of whom 438 completed the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C 30, QLQ-NMIBC 24, and the International Prostate Symptom Scoring Tool (IPSS) prior to commencing intravesical treatment. We conducted descriptive and multivariate statistical analyses. We used hierarchical linear regression to examine associations between HRQoL (Global Health Status) and physical functioning, emotional functioning, sexual function, sexual intimacy, and the IPSS total and bother scores. Results: Participants were predominately male (82%), with a mean age of 74.9 years. Over half reported moderate urinary symptoms that affected quality of life. Emotional functioning (β = 0.411, p < 0.001) and physical functioning (β = 0.355, p < 0.001) were the strongest predictors of HRQoL after adjusting for covariates. Conclusions: Individuals diagnosed with high-risk NMIBC report notable physical and emotional concerns prior to commencing intravesical therapy. Targeted interventions may be required to optimise physical and psychological reserve before treatment.