Abstract
Purpose
There are few recent longitudinal studies investigating the quality of life of colorectal cancer patients in the early years following diagnosis. This study aimed to (i) compare the health status of people with colorectal cancer less than 1 year from diagnosis with health status 1 year later and (ii) determine the characteristics associated with a change in overall health status.
Methods
The study was conducted as part of a larger trial. Participants (n = 539) were identified via the Victorian Cancer Registry in Australia, completed a computer-assisted baseline telephone interview (including the EQ-5D-3L) within 6–12 months of diagnosis, and mailed a survey 12 months later.
Results
At baseline, the majority of participants (55 %) reported some problems, including difficulties in usual activities (26 %), pain or discomfort (25 %), anxiety or depression (23 %) and mobility issues (15 %). Sixty-nine percent had either an unchanged or increased health utility score from baseline to follow-up. The largest proportion reporting an increase in problems between baseline and follow-up related to pain or discomfort (18 %). While visual analogue scale scores indicated a significantly improved health state over time overall, 32 % reported a decreased health utility score from baseline to follow-up. Those aged over 80 years were more likely to report a decreased health utility score compared to 60–80-year-olds.
Conclusions
A sizeable minority of patients experience ongoing problems in their daily lives and should be offered assistance in overcoming disabilities and returning to best possible functioning, particularly older patients who appear to be vulnerable to poor outcomes.
Similar content being viewed by others
References
Murray CJ, Vos T, Lozano R et al (2013) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2197–223
Begg S, Vos T, Barker B et al (2008) Burden of disease and injury in Australia in the new millennium: measuring health loss from diseases, injuries and risk factors. Med J Aust 188(1):36–40
Wilson T, Birks Y, Alexander D (2010) A qualitative study of patient perspectives of health-related quality of life in colorectal cancer: comparison with disease-specific evaluation tools. Color Dis 12(8):762–9
Trentham-Dietz A, Remington P, Moinpour C et al (2003) Health-related quality of life in female long-term colorectal cancer survivors. Oncologist 8(4):342–9
Ramsey SD, Berry K, Moinpour C et al (2002) Quality of life in long term survivors of colorectal cancer. Am J Gastroenterol 97:1228–34
Ramsey SD, Andersen MR, Etzioni R et al (2000) Quality of life in survivors of colorectal carcinoma. Cancer 88(6):1294–303
Engel J, Kerr J, Schlesinger-Raab A et al (2003) Quality of life in rectal cancer patients: a four year prospective study. Ann Surg 238(2):203–13
Wilson T, Alexander D, Kind P (2006) Measurement of health-related quality of life in the early follow-up of colon and rectal cancer. Dis Colon Rectum 49(11):1692–702
Hamashima C (2002) Long-term quality of life of postoperative rectal cancer patients. J Gastroenterol Hepatol 17(5):571–6
Ulander K, Jeppsson B, Grahn G (1997) Quality of life and independence in activities of daily living preoperatively and at follow-up in patients with colorectal cancer. Support Care Cancer 5(5):402–9
Camilleri-Brennan J, Steele R (2001) Prospective analysis of quality of life and survival following mesorectal excision for rectal cancer. Br J Surg 88(12):1617–22
Dunn J, Ng S, Breitbart W et al (2013) Health related quality of life and life satisfaction in colorectal cancer survivors: trajectories of adjustment. Health Qual Life Outcomes 11:46
Camilleri-Brennan J, Steele RJ (2001) The impact of recurrent rectal cancer on quality of life. Eur J Surg Oncol 27(4):349–53
Jansen L, Hoffmeister M, Chang-Claude J et al (2011) Benefit finding and post-traumatice growth in long-term colorectal cancer survivors: prevalence, determinants, and associations with quality of life. Britich Journal of Cancer 105:1158–65
Tsunoda A, Nakao K, Tsunoda Y et al (2010) Health-related quality of life of colorectal cancer patients receiving oral UFT plus leucovorin compared with those with surgery alone. Int J Clin Oncol 15(2):153–60
Carey M, Sanson-Fisher R, Macrae F et al (2012) Improving adherence to surveillance and screening recommendations for people with colorectal cancer and their first degree relatives: a randomised controlled trial. BMC Cancer 12(1):62
Courtney RJ, Paul CL, Carey ML et al (2013) A population-based cross-sectional study of colorectal cancer screening practices of first-degree relatives of colorectal cancer patients. BMC Cancer 13(1):13
Rabin R, de Charro F (2001) EQ-SD: a measure of health status from the EuroQol Group. Ann Med 33(5):337–43
McDowell I (2006) Measuring health: a guide to rating scales and questionnaires, 3rd edn. Oxford University Press, New York, Available from: http://a4ebm.org/sites/default/files/Measuring%20Health.pdf
Australian Bureau of Statistics (2003) ASGC remoteness classification: purpose and use. ABS, Canberra
Viney R, Norman R, King MT et al (2011) Time trade-off derived EQ-5D weights for Australia. Value Health 14(6):928–36
Korfage I, Essink-Bot M-L, Janssens A et al (2006) Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up. Br J Cancer 94:1093–8
Costanzo E, Lutgendorf S, Mattes M et al (2007) Adjusting to life after treatment: distress and quality of life following treatment for breast cancer. Br J Cancer 97:1625–31
Osborn R, Demoncada A, Feuerstein M (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analysis. Int J Psychiatry Med 36(1):13–34
Fryback DG, Dunham NC, Palta M et al (2009) U.S. norms for six generic health-related quality-of-life indexes from the national health measurement study. Med Care 45(12):1162–70
Pickard S, Wilke C, Lin H-W et al (2007) Health utilities using the EQ-5D in studies of cancer. Pharmacoeconomics 25(5):365–84
Boyes A, D’Este C, Girgis A et al (2013) Prevalence and predictors of the short-term trajectory of anxiety and depression in the first year after a cancer diagnosis: a population-based longitudinal study. J Clin Oncol 31:2724–9
Ferrell B, McCaffery M, Rhiner M (1992) Pain and addiction: an urgent need for change in nursing educations. J Pain Symptom Manag 7(2):117–24
Glajchen M, Fitzmartin R, Blum D et al (1995) Psychosocial barriers to cancer pain relief. Cancer Pract 3:76–82
Miaskowski C, Dodd M, West C et al (2001) Lack of adherence with the analgesic regimen: a significant barrier to effective cancer pain management. J Clin Oncol 19:4275–9
Paice J, Toy C, Shott S (1998) Barriers to cancer pain relief: fear of tolerance and addiction. J Pain Symptom Manag 16:1–9
Pargeon K, Hailey B (1999) Barriers to effective cancer pain management: a review of the literature. J Pain Symptom Manag 18:358–68
Von-Roem J, Cleeland C, Gonin R et al (1993) Physician attitudes and practice in cancer pain management. A survey from the Eastern Cooperative Oncology Group. Ann Intern Med 119:121–6
Ward S, Goldberg N, Miller-McCauley V et al (1993) Patient-related barriers to management of cancer pain. Pain 52:319–24
Hulbert-Williams N, Neal R, Morrison V et al (2012) Anxiety, depression and quality of life after cancer diagnosis: what psychosocial variables best predict how patients adjust? Psychooncology 21(8):857–67
Author contribution
All of the authors have contributed to drafting and editing the paper; RSF, CD, DH and FM contributed to development of the concept; CP, MC and EC were involved in data collection; CP, EC, MC, CD, DH, FM and RSF were involved in data analysis and interpretation. All authors contributed to and approved the final manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare they have no conflicts of interest.
Funding
This research was supported by a National Health and Medical Research Council (NHMRC) grant (Grant ID 510776), a Strategic Research Partnership Grant from Cancer Council NSW to the Newcastle Cancer Control Collaborative (New-3C), and infrastructure funding from the Hunter Medical Research Institute (HMRI). Christine Paul was supported by an HMRI fellowship and is supported by an NHMRC Career Development Fellowship.
Rights and permissions
About this article
Cite this article
Paul, C.L., Cameron, E., Doran, C. et al. Experiences of colorectal cancer patients in the 2-years post-diagnosis and patient factors predicting poor outcome. Support Care Cancer 24, 4921–4928 (2016). https://doi.org/10.1007/s00520-016-3348-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-016-3348-2