Correlates of Health-Related Quality of Life in a National Sample of Older Adult, Long-Term Survivors of Colorectal Cancer

Abstract

Background: Most survivors of colorectal cancer (CRC) are older adults who are at high risk of experiencing adverse effects and decreased health-related quality of life (HRQOL) related to cancer and its treatments. Objective: This study aimed to describe HRQOL and the demographic and clinical factors associated with HRQOL among older adult, long-term survivors of CRC. Methods: A sample of older adult, long-term survivors of CRC (N = 14458) from the Surveillance Epidemiology and End Results-Medicare Health Outcomes Survey dataset was selected. Hierarchical multiple regression was used to analyze the contribution of demographic and clinical variables to HRQOL as measured by the Veterans Rand 12-item scale. Results: The mean respondent age was 79 years with an average time from diagnosis to survey being about 13 years. In the final model, gender, race, education, income, previous radiation treatment, cardiovascular disease, inflammatory bowel disease, depression, pain, fatigue, functional status, and generalhealth perception were all significantly correlated with mental HRQOL (R 2 = 0.53). For physical HRQOL, age at diagnosis, race, marital status, education, time since diagnosis, comorbid conditions, depression, pain, fatigue, functional status, and general health perception were all significant correlates (R 2 = 0.85). Symptoms were the largest contributors to mental and physical HRQOL, accounting for 43% and 50% of the variance, respectively. Conclusion: Pain, depression, and fatigue significantly affect the HRQOL of older adult survivors of CRC, underscoring the need for long-term survivorship care.

Cancer survivor late-effects, chronic health problems after cancer treatment: what’s the evidence from population and registry data and where are the gaps?

“…Studies that included PROs increase the quality of information and measure the personal impact of symptoms on survivors HRQOL rather than what is documented in routine clinical records [44]. Random sample study populations collecting PROs [23▪,45] gave greater granularity and understanding of late effects that complemented the data linkage to clinical records but encountered challenges with increasing missing PROs data over time.…”

“…Women treated for breast cancer more recently reported poorer physical and mental health than in earlier cohorts. Women with higher comorbidities had greater functional limitations which was negatively associated with health-related quality of life (HRQOL) [23▪]. Foster et al .…”

“…EORTC QLQ-C30 Survivors reported lower self-perceived cognitive function than controls. Largest difference was for those with thyroid cancer HL, NHL, CLL and MM Cognitive function was perceived as worse for survivors <50 years Burrell et al 2023 [23▪]USA Retrospective cohort study of older adults treated for breast cancer before 1995–2015. Data collected from SEER database.…”