Skip to main content

Advertisement

SpringerLink
Log in

Distance from treating hospital and colorectal cancer survivors’ quality of life: a gendered analysis

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Distance from residence to hospital has been associated with clinical outcomes for colorectal cancer patients. However, little is known about the association of remoteness with quality of life (QoL) for colorectal cancer survivors. We examined the relationship between distance from hospital and colorectal cancer survivors’ QoL, with a specific focus on gender.

Methods

Colorectal cancer survivors in Ireland who were more than 6-months postdiagnosis completed the European Organization for Research and Treatment of Cancer QLQ-C30, measuring global health status (GHS) and physical, role, cognitive, social, and emotional functioning. Bootstrap linear regression was used to evaluate the association between remoteness and QoL scales, controlling for demographic and clinical variables. Separate models were generated for the full sample, for women, and for men.

Results

The final analytical sample was 496 colorectal cancer survivors; 186 women and 310 men. Living remote from the treating hospital was associated with lower physical functioning (coefficient −4.38 [95 % confidence interval −8.13, −0.91]) and role functioning (coeff. −7.78 [−12.64, −2.66]) among all colorectal cancer survivors. In the separate gender models, remoteness was significantly associated with lower physical (coeff. −7.00 [−13.47, −1.49]) and role functioning (coeff. −11.50 [−19.66, −2.65]) for women, but not for men. Remoteness had a significant negative relationship to GHS (coeff. −4.31 [−8.46, −0.27]) for men.

Conclusions

Aspects of QoL are lower among colorectal cancer survivors who live far from their treating hospital. There are gender differences in how remoteness is related to QoL domains. The results of this study suggest that policy makers, service providers, and health care professionals should consider the specific QoL needs of remote colorectal cancer survivors, and be attuned to and prepared to address the differing needs of men and women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fazio L, Cotterchio M, Manno M et al (2005) Association between colonic screening, subject characteristics, and stage of colorectal cancer. Am J Gastroenterol 100:2531–2539. doi:10.1111/j.1572-0241.2005.00319.x

    Article  PubMed  Google Scholar 

  2. Jones AP, Haynes R, Sauerzapf V et al (2008) Travel times to health care and survival from cancers in Northern England. Eur J Cancer 44:269–274. doi:10.1016/j.ejca.2007.07.028

    Article  CAS  PubMed  Google Scholar 

  3. Campbell NC, Elliott AM, Sharp L et al (2002) Impact of deprivation and rural residence on treatment of colorectal and lung cancer. Br J Cancer 87:585–590

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Jones AP, Haynes R, Sauerzapf V et al (2008) Travel time to hospital and treatment for breast, colon, rectum, lung, ovary and prostate cancer. Eur J Cancer 44:992–999. doi:10.1016/j.ejca.2008.02.001

    Article  CAS  PubMed  Google Scholar 

  5. Goldsbury D, Harris MF, Pascoe S et al (2012) Socio-demographic and other patient characteristics associated with time between colonoscopy and surgery, and choice of treatment centre for colorectal cancer: a retrospective cohort study. BMJ Open 2. doi:10.1136/bmjopen-2012-001070

  6. Baade PD, Dasgupta P, Aitken JF et al (2011) Distance to the closest radiotherapy facility and survival after a diagnosis of rectal cancer in Queensland. Med J Aust 195:350–354

    Article  PubMed  Google Scholar 

  7. Cramb SM, Mengersen KL, Turrell G et al (2012) Spatial inequalities in colorectal and breast cancer survival: premature deaths and associated factors. Health Place 18:1412–1421

    Article  PubMed  Google Scholar 

  8. Dunn J, Ng SK, 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

    Article  PubMed Central  PubMed  Google Scholar 

  9. Lundy JJ, Coons SJ, Wendel C et al (2009) Exploring household income as a predictor of psychological well-being among long-term colorectal cancer survivors. Qual Life Res 18:157–161

    Article  PubMed Central  PubMed  Google Scholar 

  10. Ramsey SD, Andersen MR, Etzioni R et al (2000) Quality of life in survivors of colorectal carcinoma. Cancer 88:1294–1303. doi:10.1002/(SICI)1097-0142(20000315)88:6<1294::AID-CNCR4>3.0.CO;2-M

    Article  CAS  PubMed  Google Scholar 

  11. Schultz AA, Winstead-Fry P (2001) Predictors of quality of life in rural patients with cancer. Cancer Nurs 24:12–19

    Article  CAS  PubMed  Google Scholar 

  12. Phipps E, Braitman LE, Stites S et al (2008) Quality of life and symptom attribution in long-term colon cancer survivors. J Eval Clin Pract 14:254–258. doi:10.1111/j.1365-2753.2007.00842.x

    Article  PubMed  Google Scholar 

  13. Mullan F (1985) Seasons of survival: reflections of a physician with cancer. N Engl J Med 313:270–273. doi:10.1056/NEJM198507253130421

    Article  CAS  PubMed  Google Scholar 

  14. A National Action Plan for Cancer Survivorship: advancing Public Health Strategies. Center for Disease Control and the Lance Armstrong Foundation 2004. http://www.cdc.gov/cancer/survivorship/pdf/plan.pdf. Accessed 11 Mar 2014

  15. Mullan F (1984) Re-entry: the educational needs of the cancer survivor. Health Educ Q Published Online First: http://psycnet.apa.org/psycinfo/1984-32234-001. Accessed 14 Feb 2014

  16. Taylor PJ (1975) Distance decay models in spatial interactions. http://www.getcited.org/pub/101710242. Accessed 14 Mar 2014

  17. Arcury TA, Gesler WM, Preisser JS et al (2005) The effects of geography and spatial behavior on health care utilization among the residents of a Rural Region. Health Serv Res 40:135–156. doi:10.1111/j.1475-6773.2005.00346.x

    Article  PubMed Central  PubMed  Google Scholar 

  18. Baldwin L-M, Cai Y, Larson EH et al (2008) Access to cancer services for rural colorectal cancer patients. J Rural Health Off J Am Rural Heal Assoc Natl Rural Health Care Assoc 24:390–399. doi:10.1111/j.1748-0361.2008.00186.x

    Article  Google Scholar 

  19. Bain NS, Campbell NC, Ritchie LD et al (2002) Striking the right balance in colorectal cancer care—a qualitative study of rural and urban patients. Fam Pract 19:369–374

    Article  PubMed  Google Scholar 

  20. Archampong D, Borowski D, Wille-Jørgensen P et al (2012) Workload and surgeon’s specialty for outcome after colorectal cancer surgery. Cochrane Database Syst Rev 3, CD005391. doi:10.1002/14651858.CD005391.pub3

    PubMed  Google Scholar 

  21. McIntyre P (2004) Ireland’s bumpy road to a world-class cancer service. Cancer World 54–8

  22. Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  23. Groenvold M, Klee MC, Sprangers MA et al (1997) Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient-observer agreement. J Clin Epidemiol 50:441–450

    Article  CAS  PubMed  Google Scholar 

  24. Fayers P, Aaronson N, Bjordal K et al (2001) The EORTC QLQ-C30 scoring manual. 3rd ed. Brussels: European Organisation for Research and Treatment of Cancer. http://www.eortc.be/qol/files/SCManualQLQ-C30.pdf. Accessed 1 Oct 2013

  25. Bazzoli GJ, Lee W, Hsieh H-M et al (2012) The effects of safety net hospital closures and conversions on patient travel distance to hospital services. Health Serv Res 47:129–150. doi:10.1111/j.1475-6773.2011.01318.x

    Article  PubMed Central  PubMed  Google Scholar 

  26. Thomas AA, Timmons A, Molcho M et al Quality of life in urban and rural settings: a study of head and neck cancer survivors. Oral Oncol, in Press

  27. Jansen L, Koch L, Brenner H et al (2010) Quality of life among long-term (≥5 years) colorectal cancer survivors–systematic review. Eur J Cancer 46:2879–2888

    Article  CAS  PubMed  Google Scholar 

  28. Bloom JR, Petersen DM, Kang SH (2007) Multi-dimensional quality of life among long-term (5+ years) adult cancer survivors. Psychooncology 16:691–706. doi:10.1002/pon.1208

    Article  PubMed  Google Scholar 

  29. StataCorp (2011) Stata Statistical Software: Release 12. StataCorp LP, College Station

    Google Scholar 

  30. McGowan EL, Speed-Andrews AE, Rhodes RE et al (2013) Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity. Support Care Cancer 21:139–147

    Article  PubMed  Google Scholar 

  31. Grimmett C, Bridgewater J, Steptoe A et al (2011) Lifestyle and quality of life in colorectal cancer survivors. Qual Life Res 20:1237–1245. doi:10.1007/s11136-011-9855-1

    Article  PubMed  Google Scholar 

  32. Courneya KS, Friedenreich CM, Quinney HA et al (2003) A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care (Engl) 12:347–357. doi:10.1046/j.1365-2354.2003.00437.x

    Article  CAS  Google Scholar 

  33. Vlassoff C, Moreno CG (2002) Placing gender at the centre of health programming: challenges and limitations. Soc Sci Med 54:1713–1723

    Article  PubMed  Google Scholar 

  34. Hanly P, Céilleachair AÓ, Skally M et al (2013) How much does it cost to care for survivors of colorectal cancer? Caregiver’s time, travel and out-of-pocket costs. Support Care Cancer 21:2583–2592

    Article  PubMed  Google Scholar 

  35. Lengerich EJ, Kluhsman BC, Bencivenga M et al (2007) Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities. J Cancer Surviv 1:205–211. doi:10.1007/s11764-007-0025-y

    Article  PubMed  Google Scholar 

  36. Giudice MED, Grunfeld E, Harvey BJ et al (2009) Primary care physicians’ views of routine follow-up care of cancer survivors. J Clin Oncol 27:3338–3345. doi:10.1200/JCO.2008.20.4883

    Article  PubMed  Google Scholar 

  37. Snyder CF, Earle CC, Herbert RJ et al (2008) Trends in follow-up and preventive care for colorectal cancer survivors. J Gen Intern Med 23:254–259. doi:10.1007/s11606-007-0497-5

    Article  PubMed Central  PubMed  Google Scholar 

  38. Arndt V, Merx H, Stegmaier C et al (2006) Restrictions in quality of life in colorectal cancer patients over three years after diagnosis: a population based study. Eur J Cancer 42:1848–1857. doi:10.1016/j.ejca.2006.01.059

    Article  PubMed  Google Scholar 

  39. Ramsey SD, Berry K, Moinpour C et al (2002) Quality of life in long term survivors of colorectal cancer. Am J Gastroenterol 97:1228–1234

    Article  PubMed  Google Scholar 

  40. Gray NM, Hall SJ, Browne S et al Predictors of anxiety and depression in people with colorectal cancer. Support Care Cancer 1–8. doi:10.1007/s00520-013-1963-8

  41. Traa MJ, De Vries J, Roukema JA et al (2012) Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review. Ann Oncol 23:19–27

    Article  CAS  PubMed  Google Scholar 

  42. Milbury K, Cohen L, Jenkins R et al (2013) The association between psychosocial and medical factors with long-term sexual dysfunction after treatment for colorectal cancer. Support Care Cancer 21:793–802

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Data collection for this study was supported by the Health Research Board (SA/2004/1). This analysis was supported by Health Research Board Interdisciplinary Capacity Enhancement Award (ICE/2012/09). We thank Aileen Timmons at the National Cancer Registry Ireland for feedback on analysis and a draft of the manuscript, Eamonn O’Leary at the National Cancer Registry Ireland for statistical advice, and Ciaran O’Neill at National University of Ireland, Galway for reviewing a draft of the manuscript. Geographic information system support was provided by Neil McCluskey and Sandra Deady at the National Cancer Registry Ireland. Finally, we are grateful to the tumor registration officers and data team at the National Cancer Registry Ireland.

Disclosures

None

Author information

Authors and Affiliations

  1. Health Promotion Research Centre, National University of Ireland, Aras na Coiribe, Galway, Ireland

    Audrey Alforque Thomas

  2. School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland

    Pamela Gallagher

  3. Centre for Policy Studies, University College Cork, 6 Bloomfield Terrace, Western Road, Cork, Ireland

    Alan O’Céilleachair

  4. National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland

    Alison Pearce & Linda Sharp

  5. School of Health Sciences, National University of Ireland, Galway, Ireland

    Michal Molcho

Authors
  1. Audrey Alforque Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pamela Gallagher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alan O’Céilleachair
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alison Pearce
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Linda Sharp
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michal Molcho
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Audrey Alforque Thomas.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thomas, A.A., Gallagher, P., O’Céilleachair, A. et al. Distance from treating hospital and colorectal cancer survivors’ quality of life: a gendered analysis. Support Care Cancer 23, 741–751 (2015). https://doi.org/10.1007/s00520-014-2407-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-014-2407-9

Keywords

Search

Navigation