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A five-year prospective study of quality of life after colorectal cancer

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Abstract

Purpose

Long-term (≥5 years) quality of life after colorectal cancer is not well described. The present study assessed quality of life (QOL) and psychological distress in colorectal cancer survivors more than 5 years to describe changes over time and antecedents of long-term outcomes.

Method

A prospective survey of a population-based sample of 763 colorectal cancer patients assessed socio-demographic variables, health behaviors, optimism, threat appraisal, and perceived social support at 5 months post-diagnosis as predictors of QOL and psychological distress 5 years post-diagnosis.

Results

QOL improved over time (P < 0.01 for each measure); however, measures of psychological distress remained stable (P > 0.07 for each measure). Risk factors for poorer QOL and/or greater psychological distress included: later stage disease, having a permanent stoma, rectal cancer, fatigue, smoking, being single, low social support, low optimism, and a more negative cancer threat appraisal. Being women, having a pet, having a private health insurance, and receiving both surgery and adjuvant treatment were protective.

Conclusion

Consistent with response shift theory, the antecedents of QOL after colorectal cancer are multifactorial and include predisposing socio-demographic, medical, and psychological variables. Psychosocial interventions that target both social support and threat appraisal may be effective for this patient group. Additional stepped-up support may be needed for people from a poorer social environment who have multiple risk factors for poorer adjustment. Health system effects require further investigation.

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Abbreviations

QOL:

Quality of life

CRC:

Colorectal cancer

BMI:

Body mass index

PA:

Physical activity

FACT-C:

Functional Assessment of Cancer Therapy-Colorectal

FACT-G:

Functional Assessment of Cancer Therapy-General

BSI-18:

Brief Symptoms Inventory-18

GSI:

Global Severity Index

BS:

Baseline

LT:

Long term

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Acknowledgments

This project was funded by the Cancer Council Queensland. We thank Rachel Austin and Monica West for research support.

Conflict of interest

There are no conflicts of interest for any authors.

Author information

Authors and Affiliations

  1. Griffith Health Institute, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia

    Suzanne K. Chambers, Pip Youl, Joanne Aitken, Jeff Dunn & Peter Baade

  2. Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia

    Suzanne K. Chambers, Xingqiong Meng, Pip Youl, Joanne Aitken, Jeff Dunn & Peter Baade

  3. Centre for Clinical Research, University of Queensland, Brisbane, Australia

    Suzanne K. Chambers

  4. School of Public Health, Queensland University of Technology, Brisbane, Australia

    Joanne Aitken & Peter Baade

  5. School of Social Science, University of Queensland, Brisbane, Australia

    Jeff Dunn

Authors
  1. Suzanne K. Chambers
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Correspondence to Suzanne K. Chambers.

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Chambers, S.K., Meng, X., Youl, P. et al. A five-year prospective study of quality of life after colorectal cancer. Qual Life Res 21, 1551–1564 (2012). https://doi.org/10.1007/s11136-011-0067-5

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