| Objectives: The objectives of the hospital-based cross-sectional study were 1) to evaluate cancer patients' quality of life and the associated factors in Tianjin; 2) to assess the overall validity of a number of quality of life instruments in Chinse cancer patients.Methods: A structured questionnaire was administrated to cancer patients admitted to Tianjin Cancer Hospital by pre-trained interviewers between August and December 2004. Information collected for this study included socio-demographic characteristics, personal life-style factors, and medical histories. Quality of life was measured using three instruments including the Illness Intrusiveness Rating Scales, IIRS), SF-36, and the EORTC QLQ-C30. Exploratory data analyses were used to display the distribution of general characteristics, disease and treatment characteristics. One-way analysis of variance (ANOVA) and Logistic Regression analyses were used to assess the relationships between the variables of interest and quality of life. Principal Component Analysis, goodness-of-the fit test, and split-half techniques were used to evaluate the validity of the Illness Intrusiveness Rating Scale.Results: A total of 641 cancer patients were recruited for this study. The cancer site distributions were breast cancer 202 (31.51%), lung cancer 229 (35.73%), head and neck cancer 119 (18.56%), stomach cancer 76 (11.86%) and liver cancer 25 (3.90%). The mean age of the participants was 55.9 (s=11.22) with a male to female ratio of 0.83. The mean score of Global Quality of Life was 53.71 for breast cancer patients (s=15.55), 45.05 for lung cancer patients (s=16.06), and 59.42 for head and neck cancer patients (s=18.63), 50.89 and 46.88 for stomach (s=18.36) and liver cancer patients (s=lS.18). There were significant differences among the five different cancers (F=13.27, P＜0.01). Head and neck cancer patients and the breast cancer patients had better quality of life, and the quality of life for liver cancer patients was the poorest among the five studied cancers.Age, gender, marriage status, family income, education attainment were the significant impact factors affecting quality of life of cancer patients. Older age was significantly adversely associated with a number of aspects of quality of life including: Physical Function, Emotional Function, Role Function, Pain, and etc. Gender was an important impact factor to Physical Function and Role Function. Marital status was a statistically significant factor for the patients' Cognitive Function and the Global Quality of Life with higher scores in married participants.Exploratory Principal Component Analysis identified a two-factor structure, "Instrumental" and "Relationships and Personal Development (RPD)", accounting for 58.96% of the variance. However, a goodness-of-the fit test supports a two-factor solution (P=0.07). The study also suggests a good agreement between IIRS and the EORTC QLQ-C30.Cancer seems to have a differential impact between the genders. In the Role Functiofial, male patients' scores were higher than the female patients' (P＜0.05). However, male patients' scores in the Social Functional were lower than the female's (P＜0.05). There was little difference in the Symptom Scales and Symptom Items, except for Nausea/Vomiting and Diarrhea.Conclusion: The study evaluated cancer patients' quality of life and the associated factors in Tianjin, and also assessed the overall validity of a number of quality of life instruments in Chinese cancer patients. The results have important clinical and public health implications toward improving the overall quality of life in cancer patients through more efficient interventions.
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