Validation of Malayalam Translation of Functional Assessment of Cancer Therapy-Esophageal (FACT-E) Questionnaire

Oesophageal cancer has long been considered as one of the most deadly diseases. Recent advances in the perioperative management of this cancer has brought about some progress in prolonging survival. With the significant improvements in survival, attention has turned to studying the changes in Quality of Life (QoL) in these patients. This needs a specific and comprehensible tool to be used in the local patient population. We intend to determine whether this QoL questionnaire can be used to assess the QoL in patients from Kerala with oesophageal cancer. The Functional Assessment of Cancer Therapy-Esophagus (FACT-E) English questionnaire, specific for oesophageal cancer, was cross-culturally translated to the local language, Malayalam, and was used in a prospective study in 98 consecutive oesophageal cancer patients. Its reliability and validity was assessed in this group of patients. The internal consistency of the FACT-E tool was evaluated using Cronbach's alpha. After validating the FACT-E Malayalam questionnaire, we found that Cronbach's alpha coefficient was more than 0.7, indicating good reliability. The various subscales studied showed good correlation. Good convergent and discriminant validities were obtained. Correlation was found to be more than 0.4 and was deemed acceptable. The face validity was examined and was found to be satisfactory. The FACT-E Malayalam questionnaire is shown to be a reliable and valid tool that can be used to prospectively evaluate the quality of life of patients speaking Malayalam language and can be a useful accessory for future trials assessing QoL in such patients with oesophageal cancer.