Quality of Life of Patients with Upper Gastrointestinal Cancer at Kenyatta National Hospital Cancer Treatment Centre, Nairobi City County, Kenya

Abstract

Background: Upper gastrointestinal (GI) cancers substantially impair health-related quality of life (HRQoL). In Kenya, these malignancies rank among the leading causes of cancer mortality and are frequently diagnosed at advanced stages.

Objectives: To assess HRQoL among patients with upper GI cancers at Kenyatta National Hospital Cancer Treatment Centre (KNH-CTC) and to identify associated sociodemographic, clinical, treatment and hospital-related factors.

Methods: Analytical cross-sectional study of 131 consecutive patients with histologically confirmed oesophageal, gastric or oral cavity cancer receiving active treatment at KNH-CTC (July–August 2025). HRQoL was measured with the EORTC QLQ-C30 (version 3). Good HRQoL was defined a priori as global health status/QoL ≥60, all functional scales ≥60 and all symptom scales <60. Data were analysed using SPSS v28 with descriptive statistics, χ² tests, and multivariable logistic regression.

Results: Only 25.3% (n=33) met criteria for good HRQoL; 74.7% had poor HRQoL. The mean global health status score was 48.0 ± 1.3. Role functioning (38.7) and social functioning (28.1) were severely impaired. Dominant symptoms were financial difficulties (84.8), fatigue (80.3) and appetite loss (73.9). Multivariable analysis identified late-stage disease (adjusted odds ratio [AOR], 4.10; p=0.002) and lack of financial access to oncology services (AOR, 3.62; p=0.002) as independent predictors of poor HRQoL. Married patients had significantly better HRQoL (p=0.042).

Conclusion: Patients with upper GI cancers at KNH-CTC experience substantially impaired HRQoL, driven primarily by advanced stage at presentation and financial toxicity. Strengthening early detection, expanding financial protection under the Social Health Authority, and integrating nutritional, psychological and palliative support are urgently required.