Symptom impact and health-related quality of life (HRQoL) assessment by cancer stage: a narrative literature review

Sep 21, 2026

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Cancer stage at diagnosis is a key prognostic indicator, yet how stage affects patient-reported outcomes remains insufficiently understood. This narrative literature review evaluated symptom burden and health-related quality of life (HRQoL) impact across ten cancer types by stage. Ten narrative reviews were used to compile English-language journal and selected conference abstract evidence from 2012–2022. Results showed worse outcomes in advanced-stage patients, with greater symptom impact and poorer HRQoL, including anxiety and depression.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages23

Reading Time58 min

AccessFree to download

Abstract

Background

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Chung et al. BMC Cancer (2024) 24:884 [https://doi.org/10.1186/s12885-024-12612-z](https://doi.org/10.1186/s12885-024-12612-z) BMC Cancer RESEARCH Open Access Symptom impact and health-related quality of life (HRQoL) assessment by cancer stage: a narrative literature review Karen C. Chung 1*, Anushini Muthutantri2, Grace G. Goldsmith2, Megan R. Watts2, Audrey E. Brown2 and Donald L. Patrick3 Abstract Background Cancer stage at diagnosis is an important prognostic indicator for patient outcomes, with detection at later stages associated with increased mortality and morbidity. The impact of cancer stage on patient-reported outcomes is poorly understood. This research aimed to understand symptom burden and health related quality of life (HRQoL) impact by cancer stage for ten cancer types: 1) ovarian, 2) lung, 3) pancreatic, 4) esophageal, 5) stomach, 6) head and neck, 7) colorectal, 8) anal, 9) cervical, and 10) liver and bile duct. Methods Ten narrative literature reviews were performed to identify and collate published literature on patient burden at different stages of disease progression. Literature searches were conducted using an AI-assisted platform to identify relevant articles published in the last five (2017–2022) or ten years (2012–2022) where articles were limited. Conference abstracts were searched for the last two years (2020–2022) . The geographic scope was limited to the United States, Canada, Europe, and global studies, and only journal articles written in English were included. Results A total of 26 studies with results stratified by cancer stage at diagnosis (and before treatment) were selected for the cancer types of lung, pancreatic, esophageal, stomach, head and neck, colorectal, anal, and cervical cancers. Two cancer types, ovarian cancer, and liver and bile duct cancer did not return any search results with outcomes stratified by disease stage. A general trend was observed for worse patient-reported outcomes in patients with cancer diagnosed at an advanced stage of disease compared with diagnosis at an earlier stage. Advanced disease stage was associated with greater symptom impact including general physical impairments such as pain, fatigue, and interference with functioning, as well as disease/region-specific symptom burden. Poorer HRQoL was also associated with advanced disease with commonly reported symptoms including anxiety and depression. Conclusions Overall, the general trend for greater symptom burden and poorer HRQoL seen in late stage versus early-stage disease across the included cancer types supports the importance for early diagnosis and treatment to improve patient survival and decrease negative impacts on disease burden and HRQoL. Keywords Cancer, Patient reported outcomes, Health related quality of life, Early detection, Cancer screening *Correspondence: Karen C. Chung [kchung@grailbio.com](kchung@grailbio.com) 1GRAIL, Inc., 1525 O’Brien Dr, Menlo Park, CA 94025, USA 2Genesis Research Group, West One, Forth Banks, Newcastle upon Tyne NE1 3PA, UK 3 University of Washington, 1959 NE Pacific St, Box 357660, Seattle, WA 98195, USA Introduction Cancer stage at diagnosis is an important prognostic indicator for patient outcomes, with detection at later stages associated with increased mortality and morbidity. An estimated 2,001,140 new cancer cases will occur in the United States in 2024 along with 611,720 cancer © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If mat

FAQs

What was the objective of this narrative literature review?

To understand symptom burden and HRQoL impact by cancer stage across ten cancer types.

How were the included studies selected?

The authors performed ten narrative literature reviews, searching for articles published in defined recent windows and restricting to English-language journal articles, with additional selection of conference abstracts.

What overall trend did the results show regarding cancer stage?

Patients diagnosed at an advanced stage generally reported worse outcomes than those diagnosed at an earlier stage, including greater symptom impact and poorer HRQoL.

Sep 21, 2026

Uploaded by Noah