International phase IV field study to validate the European Organisation for Research and Treatment of Cancer questionnaire for assessing the health-related quality of life of cancer survivors: The EORTC QLQ-SURV100
- Author(s)
- Fox, L; van Leeuwen, M; Jones, JM; Al-Omari, A; Abaza, H; Al-Khaifi, M; Eichler, M; Hartup, S; Velikova, G; Friðriksdóttir, N; Cho, J; Vanlaer, N; Rogiers, A; Costi, S; Soncini, S; Kjær, TK; Arndt, V; Doege, D; Alkan, A; Ishiki, H; Rammant, E; Baumann, J; Sinn, M; Annunziata, MA; Arraras, JI; van Hemelrijck, M; Pace, A; Clatworthy, N; King, V; Tolstrup, LK; Shimomura, A; Kontogianni, M; Sodergren, SC; Vukšić, N; Petersen, MA; Kieffer, JM; Jefford, M; Chalk, T; Young, T; Borda, N; Morag, O; Harle, A; Petranović, D; Meggiolaro, E; De Padova, S; Jansen, F; Turhal, NS; Navarra, CM; Baumann, I; Amdal, CD; Vassiliou, V; Pinto, M; Kurosawa, S; Vistad, I; Al-Balushi, M; Al-Ghoche, A; Dirven, L; Capela, A; Elsayed, Z; Montemuiño, S; Willisch, P; Aaronson, N; van de Poll-Franse, L; EORTC Quality of Life Group;
- Journal Title
- European Journal of Cancer
- Publication Type
- Research article
- Abstract
- INTRODUCTION: Cancer survivors face unique and persistent health-related quality of life (HRQoL) challenges. Existing HRQoL questionnaires for survivors lack content regarding chronic physical issues and have typically included limited cancer types and languages/cultures, affecting breadth of content and generalisability. We developed and validated the EORTC QLQ-SURV100, a questionnaire to assess HRQoL in disease-free survivors of diverse cancers. A conceptual framework of HRQoL in cancer survivors, developed in previous study phases and conceptualised as survivors' self-reported physical, mental and social functioning and well-being, formed the basis for questionnaire content. METHODS: The QLQ-SURV100 was administered to 1480 participants across 46 centres in 21 countries (31% breast cancer, 23% colorectal, 22% prostate, 24% other cancers), who had completed primary treatment 1-10 years earlier and had no evidence of active disease. Structural validity of the 21 multi-item questionnaire scales was assessed via confirmatory factor analysis; test-retest reliability via intraclass correlation coefficients (ICCs); construct validity through known-group comparisons; and cross-cultural validity and sex invariance through differential item functioning (DIF). Item response theory (IRT) analyses evaluated item redundancy and performance. RESULTS: The QLQ-SURV100 showed strong structural validity (Comparative Fit Index = 0.951; Tucker-Lewis Index = 0.944; Root Mean Square Error of Approximation = 0.046), with most standardised factor loadings 0.7. Test-retest ICCs exceeded 0.7 for 27 of 35 scales and 0.6 for 34 scales. Known-groups analyses supported most hypotheses, confirming sensitivity to treatment, comorbidity, age, sex, and education. DIF analysis indicated minor cross-cultural item bias, but no sex-related DIF. IRT analysis found no redundant items. CONCLUSIONS: The EORTC QLQ-SURV100 showed satisfactory structural validity, test-retest reliability and construct validity; limited item redundancy; and measurement invariance across the sex and language groups examined.
- Publisher
- Elsevier
- Keywords
- Humans; *Quality of Life; Female; Male; Middle Aged; *Cancer Survivors/psychology; Reproducibility of Results; Aged; Surveys and Questionnaires; *Neoplasms/psychology/therapy; Adult; Psychometrics; Health Status; Europe; Cancer; Cancer survivors; Patient-reported outcome measures; Quality of life; Survivorship
- Department(s)
- Australian Cancer Survivorship Centre
- Publisher's Version
- https://doi.org/10.1016/j.ejca.2026.116959
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-09-03 12:44:12
Last Modified: 2026-09-03 12:44:21