Quality of Life and Mortality of Long-Term Colorectal Cancer Survivors in the Seattle Colorectal Cancer Family Registry

Abstract

Background and AimBecause most colorectal cancer patients survive beyond five years, understanding quality of life among these long-term survivors is essential to providing comprehensive survivor care. We sought to identify personal characteristics associated with reported quality of life in colorectal cancer survivors, and sub-groups of survivors potentially vulnerable to very low quality of life.MethodsWe assessed quality of life using the Veterans RAND 12-item Health Survey within a population-based sample of 1,021 colorectal cancer survivors in the Seattle Colorectal Cancer Family Registry, approximately 5 years post-diagnosis. In this case-only study, mean physical component summary scores and mental component summary scores were examined with linear regression. To identify survivors with substantially reduced ability to complete daily tasks, logistic regression was used to estimate odds ratios for “very low” summary scores, defined as a score in the lowest decile of the reference US population. All cases were followed for vital status following QoL assessment, and mortality was analyzed with Cox proportional hazards regression.ResultsLower mean physical component summary score was associated with older age, female sex, obesity, smoking, and diabetes or other co-morbidity; lower mean mental component summary score was associated with younger age and female sex. Higher odds of very low physical component summary score was associated with older age, obesity, less education, smoking, co-morbidities, and later stage at diagnosis; smoking was associated with higher odds of very low mental component summary score. A very low physical component score was associated with higher risk of mortality (hazard ratio (95% confidence interval): 3.97 (2.95–5.34)).ConclusionsOur results suggest that identifiable sub-groups of survivors are vulnerable to very low physical components of quality of life, decrements that may represent meaningful impairment in completing everyday tasks and are associated with higher risk of death.

Age-specific health-related quality of life in long-term and very long-term colorectal cancer survivors versus population controls – a population-based study

“…On the other hand, older CRC survivors reported comparable or better HRQOL than controls in the short-term, but had poorer HRQOL in the 5-10 years follow-up [12]. A previous study of longterm CRC survivors found that older age was associated with poorer physical health [13]. We could not find published studies that have specifically addressed the association of age differentials on HRQOL for very long-term CRC survivors.…”

Quality of life among Korean gastrointestinal cancer survivors

“…It is interesting that our results suggest that cancer stage at diagnosis was associated with QoL in the 90% quantile group. A previous study reported that regional, distant, or unstaged/unknown stage was progressively associated with a very low physical component of QoL in the 10% percentile of QoL among colorectal cancer survivors (Adams et al, 2016). Cancer survivors with higherstage disease are vulnerable to more-severe symptoms owing to massive treatments and the advanced disease itself, which are important factors of QoL status.…”

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

“…In the present study, we will expand on this previous analysis by i) investigating the association of a broad panel of clinical and sociodemographic factors (not considered in our prior analyses [ 24 ]) with HRQOL and ii) relating HRQOL prospectively to all-cause mortality. To our knowledge, so far, only one study examined the association between HRQOL and mortality in long-term CRC survivors and provided initial evidence for an inverse relation between physical and mental component scores and mortality risk [ 22 ].…”