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 5Â months post-diagnosis as predictors of QOL and psychological distress 5Â years post-diagnosis.
Results
QOL improved over time (PÂ <Â 0.01 for each measure); however, measures of psychological distress remained stable (PÂ >Â 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.
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There are no conflicts of interest for any authors.
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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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DOI: https://doi.org/10.1007/s11136-011-0067-5