Comparison of the EORTC QLQ-EN24, FACT-En, and FEnSI-23 for assessing quality of life in endometrial cancer: a systematic review

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PURPOSE OF REVIEW: Endometrial cancer is a prevalent gynecological malignancy with a rising incidence and substantial symptom burden. As treatments evolve, understanding patient-reported quality of life (QoL) has become critical. This review examines the characteristics, psychometric properties, and domain coverage of three key endometrial-cancer-specific patient-reported outcome measures to guide clinical and research applications. RECENT FINDINGS: The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer 24 (EORTC QLQ-EN24), the Functional Assessment of Cancer Therapy-Endometrial (FACT-En), and Functional Assessment of Cancer Therapy Endometrial Symptom Index (FEnSI-23) present varying structures, scopes, and focuses. The EORTC QLQ-EN24 provides detailed symptom assessment, particularly for treatment-induced effects, and has been validated in multinational settings. FACT-En offers a broader evaluation of physical, emotional, social, and functional well-being, supporting longitudinal and survivorship research. FEnSI-23, developed through patient-centered approaches, emphasizes disease-related symptoms and treatment side effects, taking the perspectives of underrepresented patient groups into account. SUMMARY: This review highlights significant differences in the scope, strengths, and psychometric properties of the EORTC QLQ-EN24, FACT-En, and FEnSI-23. While they demonstrate clinical research utility, gaps remain in cross-cultural validation and responsiveness. Prospective research should prioritize validation across diverse populations to further ascertain the measures' reliability. Instrument selection should correlate with clinical requirements, with the EORTC QLQ-EN24 suited for detailed symptom assessment, the FACT-En for broader QoL evaluation, and the FEnSI-23 for patient-centered measurement of disease symptoms and treatment side effects.

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