Format

Send to

Choose Destination
BMC Cancer. 2018 Nov 22;18(1):1156. doi: 10.1186/s12885-018-5075-1.

Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study.

Author information

1
Institute of Epidemiology, University of Kiel, University Hospital Schleswig-Holstein, Niemannsweg 11, 24105, Kiel, Germany. ilka.ratjen@epi.uni-kiel.de.
2
Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
3
Institute of Epidemiology, University of Kiel, University Hospital Schleswig-Holstein, Niemannsweg 11, 24105, Kiel, Germany.
4
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
5
Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
6
Medical Department 1, University Hospital Dresden, Technical University Dresden, Dresden, Germany.
7
Institute of Biometrics and Epidemiology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany.

Abstract

BACKGROUND:

The group of colorectal cancer (CRC) survivors continues to grow worldwide. Understanding health-related quality of life (HRQOL) determinants and consequences of HRQOL impairments in long-term CRC survivors may help to individualize survivorship care plans. We aimed to i) examine the HRQOL status of CRC long-term survivors, ii) identify cross-sectional sociodemographic and clinical correlates of HRQOL, and iii) investigate the prospective association of HRQOL after CRC diagnosis with all-cause mortality.

METHODS:

We assessed HRQOL within a Northern German cohort of 1294 CRC survivors at a median of 6 years after CRC diagnosis using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Cross-sectional correlates of different HRQOL dimensions were analyzed using multivariable-adjusted logistic regression models with HRQOL as a binary variable. With multivariable-adjusted Cox proportional hazards regression models, hazard ratios (HR) of all-cause mortality were estimated per 10-point-increments of an HRQOL summary score, a global quality of life scale, and HRQOL functioning and symptom domains.

RESULTS:

The median HRQOL summary score was 87 (interquartile range: 75-94). Sex, age, education, tumor location, metastases, other cancers, type of therapy, and current stoma were identified as correlates of different HRQOL scales. After a median follow-up time of 7 years after HRQOL assessment, 175 participants had died. Nearly all HRQOL domains, except for cognitive functioning and diarrhea, were significantly associated with all-cause mortality. A 10-point-increment in the summary score decreased the risk of death by 24% (HR: 0.76; 95% CI: 0.70-0.82).

CONCLUSIONS:

HRQOL in CRC survivors appeared to be relatively high in the long term. Various clinical and sociodemographic factors were cross-sectionally associated with HRQOL in long-term CRC survivors. Lower HRQOL was associated with increased all-cause mortality. Individualized healthcare programs for CRC survivors (including psychosocial screening and interventions) are needed to detect decreased HRQOL and to further improve long-term HRQOL and survival.

KEYWORDS:

Colorectal cancer; Correlates; Health-related quality of life; Long-term survivors; Mortality

PMID:
30466408
PMCID:
PMC6251222
DOI:
10.1186/s12885-018-5075-1
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center