Factors Affecting Low Health-Related Quality of Life and Health Issues in Gastric Cancer Survivors: A Propensity Score-Matched, Nationwide Study

Background and Aim: This study evaluated the health-related quality of life (HRQoL) of Korean gastric cancer survivors (GCSs) aged ≥ 19 years using preference-based measurements with a converted health utility index. Methods: Data from the fourth to eighth cycles of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2020 were analyzed. Propensity score matching (PSM) was performed to mitigate baseline covariate imbalances between the GCS group and the non-GCS group. The EuroQol (EQ)-5D-3L questionnaire and EQ-5D index were used to evaluate the HRQoL of five GCSs. Results: A total of 113 091 individuals participated in the screening program. PSM found the HRQoL of the GCS group (535; 16.67%) to be significantly lower than that of the non-GCS group (2675; 83.33%) (EQ-5D index: 0.904 vs. 0.917, p = 0.039). The EQ-5D index significantly decreased by 0.014 for every increase in the GCS score (p = 0.027, 95% CI −0.02 to −0.002). Patients with activity limitation had the highest probability of experiencing issues in performing usual activities (odds ratio 8.321; 95% CI 3.707–18.678). Participants with positive subjective health perceptions had a decreased likelihood of experiencing problems (odds ratio 0.149–0.406). Factors that influenced the EQ-5D index of GCSs included activity limitation, subjective health perception, age, and sex. Conclusions: The matched cohort revealed that Korean GCSs had significantly lower HRQoL than the non-GCS population. To enhance the HRQoL of GCSs, alleviating activity limitations and improving subjective health perception simultaneously are paramount.