Comorbidities are associated with poorer quality of life and functioning and worse symptoms in the 5 years following colorectal cancer surgery: Results from the ColoREctal Well‐being (CREW) cohort study

Abstract

ObjectiveMore people are living with the consequences of cancer and comorbidity. We describe frequencies of comorbidities in a colorectal cancer cohort and associations with health and well‐being outcomes up to 5 years following surgery.MethodsProspective cohort study of 872 colorectal cancer patients recruited 2010 to 2012 from 29 UK centres, awaiting curative intent surgery. Questionnaires administered at baseline (pre‐surgery), 3, 9, 15, 24 months, and annually up to 5 years. Comorbidities (and whether they limit activities) were self‐reported by participants from 3 months. The EORTC QLQ‐C30 and QLQ‐CR29 assessed global health/quality of life (QoL), symptoms, and functioning. Longitudinal analyses investigated associations between comorbidities and health and well‐being outcomes.ResultsAt baseline, the mean age of participants was 68 years, with 60% male and 65% colon cancer. Thirty‐two per cent had 1 and 40% had ≥2 comorbidities. The most common comorbidities were high blood pressure (43%), arthritis/rheumatism (32%), and anxiety/depression (18%). Of those with comorbidities, 37% reported at least 1 that limited their daily activities. Reporting any limiting comorbidities was associated with poorer global health/QoL, worse symptoms, and poorer functioning on all domains over 5‐year follow‐up. Controlling for the most common individual comorbidities, depression/anxiety had the greatest deleterious effect on outcomes.ConclusionsClinical assessment should prioritise patient‐reported comorbidities and whether these comorbidities limit daily activities, as important determinants of recovery of QoL, symptoms, and functioning following colorectal cancer. Targeted interventions and support services, including multiprofessional management and tailored assessment and follow‐up, may aid recovery of health and well‐being in these individuals.

Do age and comorbidity impair recovery during two years after treatment for endometrial cancer?

“…In line with our findings, various studies have found that, in patients with endometrial cancer or different cancer types, independent of age, comorbidity was associated with poorer HRQoL at baseline or HRQoL deterioration at follow-up [11][12][13]32]. One previous study from our group reported on the association between changes in HRQoL and clinical and sociodemographic characteristics of patients included in the Rogy Care trial and also described the association between cumulative comorbidity burden and poorer HRQoL [12].…”

“…Various prior studies have found that age above 60 and comorbidity were independently associated with treatment-related morbidity and poorer survival [6][7][8][9][10]. Perhaps more importantly, both factors may also impact health-related quality of life (HRQoL) [11][12][13][14][15]. This outcome is of particular interest to patients suffering from cancers with a relatively good prognosis such as endometrial cancer and to older adults with cancer, who often give preference to maintenance or improvement of HRQoL rather than a small increase in survival [6,16].…”

Does quality of life return to pre-treatment levels five years after curative intent surgery for colorectal cancer? Evidence from the ColoREctal Wellbeing (CREW) study

“…Whilst having comorbidities per se may not be amenable to change, the way comorbidities are managed could be. Our previous work has shown that it is the impact of comorbidities on daily life which influences QOL [44], and personalised assessment and management for people with comorbidities may improve outcomes.…”

Cancer specialist nurses’ perspectives of physical activity promotion and the potential role of physical activity apps in cancer care

“…Furthermore, the majority of people LWBC are living with at least one other long-term chronic condition (e.g. hypertension, obesity, mental health conditions) [17, 18]. The shared risk factors between cancer and heart disease, and toxicity of cancer treatment, can also leave people LWBC at increased risk of cardiovascular disease [19, 20].…”