P200 Beyond survival: inequalities in quality of life after melanoma – a national population-based study in England between 2021 and 2025

Abstract

With increasing incidence and survival, more people are living with a melanoma diagnosis. There are few national publications on the quality of life (QoL) of people with melanoma. The aim of this study was to describe QoL in people with melanoma in England stratified by patient and tumour characteristics. This retrospective cohort study analysed anonymized and aggregated data from the Cancer QoL Survey by NHS England (July 2021 to March 2025). Adults aged ≥ 18 years with melanoma diagnoses around 18 months earlier were invited to complete the survey. The EuroQol Five Dimensions (EQ5D) index and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC) scores were analysed. Logistic regression was carried out to assess odds ratios (ORs) with 95% confidence intervals (CIs) by age, gender, deprivation and stage of diagnosis. The study response rate was 40.5%, with 16 836 respondents with melanoma included. Individuals aged < 50 years had the highest OR of anxiety or depression (EQ-5D OR 2.50, 95% CI 2.23–2.80; EORTC OR 2.74, 95% CI 2.34–3.22) compared with those aged 70–79 years. Women had higher rates than men of anxiety or depression (EQ-5D OR 1.70, 95% CI 1.60–1.81; EORTC OR 1.63, 95% CI 1.48–1.81) and difficulty sleeping (EORTC OR 1.60, 95% CI 1.48–1.73). The most deprived quintile had higher OR compared with the least deprived for poorer concentration and memory function (EORTC OR 1.90, 95% CI 1.65–2.18), poorer self-care (EQ-5D OR 2.21, 95% CI 1.87–2.61) and impaired emotional functioning (EORTC OR 2.54, 95% CI 2.13–3.03). Those with stage III/IV melanoma had the largest OR compared with stage I/II in social functioning (EORTC OR 2.08, 95% CI 1.87–2.32), followed by impacted usual activities (EQ-5D OR 1.94, 95% CI 1.74–2.15) and lack of appetite (EORTC OR 1.90, 95% CI 1.53–2.33). This study highlights how younger adults, women, those from deprived areas and individuals with advanced-stage disease experienced the greatest challenges. Future research will examine comparisons with the general population and other cancers to contextualize these findings.