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Functional quality of life among newly diagnosed young adult colorectal cancer survivors compared to older adults: results from the ColoCare Study

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Abstract

Purpose

Colorectal cancer (CRC) incidence and mortality are increasing among young adults (YAs) aged 18–39. This study compared quality of life (QOL) between YA and older adult CRC survivors in the ColoCare Study.

Methods

Participants were grouped by age (years) as follows: 18–39 (YA), 40–49, 50–64, and 65 + . Functional QOL (physical, social, role, emotional, cognitive) and global QOL were assessed with the EORTC-QLQ-C30 at enrollment, 3, 6, and 12 months. Average scores were compared between groups over time using longitudinal mixed-effect modeling. Proportions with clinically meaningful QOL impairment were calculated using age-relevant thresholds and compared between groups over time using logistic regression with mixed effects.

Results

Participants (N = 1590) were n = 81 YAs, n = 196 aged 40–49, n = 627 aged 50–64, and n = 686 aged 65 + . Average physical function was better among YAs than participants aged 50–64 (p = 0.010) and 65 + (p < 0.001), and average social function was worse among YAs than aged 65 + (p = 0.046). Relative to YAs, all age groups were less likely to report clinically meaningful social dysfunction (aged 40–49 OR = 0.13, 95%CI = 0.06–0.29; aged 50–64 OR = 0.10, 95%CI = 0.05–0.21; aged 65 + OR = 0.07, 95%CI = 0.04–0.15) and role dysfunction (aged 40–49 OR = 0.36, 95%CI = 0.18–0.75; aged 50–64 OR = 0.41, 95%CI = 0.22–0.78; aged 65 + OR = 0.32, 95%CI = 0.17–0.61). Participants aged 40–49 were also less likely to report physical dysfunction (OR = 0.42, 95%CI = 0.19–0.93).

Conclusion

YA CRC survivors reported better physical and worse social function compared to older CRC survivors, and YA CRC survivors were more likely to report clinically meaningful social, role, and physical disfunction. Future work should further investigate QOL using age-relevant benchmarks to inform best practices for CRC survivorship care.

Trial registration

NCT02328677, registered December 2014.

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Data availability

The ColoCare Study data and code are available from the corresponding author upon reasonable request and as described on the ColoCare website: (https://uofuhealth.utah.edu/huntsman/labs/colocare-consortium/). Our data sharing procedures have been updated and are available online: (https://uofuhealth.utah.edu/huntsman/labs/colocare-consortium/data-sharing/new-projects.php). For additional questions, please contact the ColoCare Study Administrator Team (colocarestudy_admin@hci.utah.edu).

Abbreviations

BMI:

Body mass index

CI:

Confidence interval

CRC:

Colorectal cancer

EORTC-QLQ-C30:

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire

OR:

Odds ratio

QOL:

Quality of life

SE:

Standard error

YA:

Young adult

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Acknowledgements

The authors would like to gratefully acknowledge Sofia Cobos, MPH, Julaxis Love, and Devon Conant for their assistance with data collection. The authors would also like to gratefully acknowledge the colorectal cancer survivors who participated in this study.

Funding

This study was supported in part by an Innovation Award via the Moffitt Cancer Center Department of Epidemiology (MPIs: Siegel, Oswald), institutional funds via the Moffitt Cancer Center AYA Program, Florida Department of Health Bankhead Coley Award (09BN-13, Siegel), and funding via the National Cancer Institute of the National Institutes of Health (U01CA206110, R01NR018762, R01CA189184, R01CA207371, R01CA254108). The ColoCare Study at the Heidelberg site was supported by the German Ministry of Education and Research projects 01KT1503 and 01KD2101D, the National Institutes of Health/National Cancer Institute (NHI/NCI) projects R01 CA189184 and U01 CA206110, the Stiftung LebensBlicke, the Matthias-Lackas Foundations, the Rahel-Goitein-Straus-Program, Medical Faculty Heidelberg University, and the Heidelberger Stiftung Chirurgie, Heidelberg University Hospital. This work was also supported in part by the Total Cancer Care Protocol and the Participant Research, Interventions, and Measurements Core at Moffitt Cancer Center, an NCI designated Comprehensive Cancer Center (P30CA076292).

Author information

Authors and Affiliations

  1. Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-HOB, Tampa, FL, 33612, USA

    Laura B. Oswald, Amanda Bloomer, Xiaoyin Li, Esther Jean-Baptiste, Gillian Trujillo, Seth Felder, Heather S. L. Jim & Erin M. Siegel

  2. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Brent J. Small

  3. Huntsman Cancer Institute, Salt Lake City, UT, USA

    Jennifer Ose, Sheetal Hardikar, Ildiko Strehli, Lyen C. Huang, Kathi Mooney & Cornelia M. Ulrich

  4. University of Utah, Salt Lake City, UT, USA

    Jennifer Ose, Sheetal Hardikar, Lyen C. Huang, Kathi Mooney & Cornelia M. Ulrich

  5. University of Applied Sciences and Arts, Hanover, Germany

    Jennifer Ose & Matthew G. Mutch

  6. Washington University School of Medicine, St. Louis, MO, USA

    Dante Chao & Adetunji T. Toriola

  7. Siteman Cancer Center, St. Louis, MO, USA

    Dante Chao & Adetunji T. Toriola

  8. Fred Hutchinson Cancer Center, Seattle, WA, USA

    Stacey A. Cohen & Christopher I. Li

  9. University of Tennessee Health Science Center, Memphis, TN, USA

    Meghana Karchi, Elizabeth H. Wood & David Shibata

  10. Heidelberg University Hospital, Heidelberg, Germany

    Victoria Damerell, Martin Schneider & Biljana Gigic

  11. Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Nicole C. Loroña, Jun Gong & Jane C. Figueiredo

Authors
  1. Laura B. Oswald
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  2. Amanda Bloomer
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  3. Xiaoyin Li
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  5. Gillian Trujillo
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  6. Seth Felder
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  7. Brent J. Small
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  8. Jennifer Ose
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  9. Sheetal Hardikar
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  11. Lyen C. Huang
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  12. Kathi Mooney
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  13. Matthew G. Mutch
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  14. Dante Chao
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  19. Nicole C. Loroña
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  20. Jun Gong
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  21. Adetunji T. Toriola
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  22. Christopher I. Li
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Contributions

LBO: conceptualization, funding acquisition, writing – original draft, writing – review and editing; AB: data curation, formal analysis, writing – original draft, writing – review and editing; XL: data curation, formal analysis, visualization, writing – original draft, writing – review and editing; EJ-B: project administration, writing – review and editing; GT: project administration, investigation, writing – review and editing; SF: project administration, writing – review and editing; BJS: data curation, writing – review and editing; JO: project administration, investigation, writing – review and editing; SH: project administration, writing – review and editing; IS: project administration, writing – review and editing; LCH: resources, writing – review and editing; KM: writing – review and editing; MGM: resources, writing – review and editing; DC: project administration, writing – review and editing; SAC: resources, writing – review and editing; MK: resources, writing – review and editing; EHW: resources, writing – review and editing; VD: project administration, writing – review and editing; NCL: project administration, writing – review and editing; JG: resources, writing – review and editing; ATT: conceptualization, funding acquisition, writing – review and editing; CIL: conceptualization, funding acquisition, writing – review and editing; DS: conceptualization, funding acquisition, writing – review and editing; MS: conceptualization, funding acquisition, writing – review and editing; BG: conceptualization, funding acquisition, writing – review and editing; JCF: conceptualization, funding acquisition, writing – review and editing; HSLJ: conceptualization, funding acquisition, writing – review and editing; CMU: conceptualization, funding acquisition, writing – review and editing; EMS: conceptualization, funding acquisition, writing – original draft, writing – review and editing.

Corresponding author

Correspondence to Laura B. Oswald.

Ethics declarations

Ethics approval

This study was performed in line with the Declaration of Helsinki. Approval was granted by the ethics committee of each recruitment site: Moffitt Cancer Center (USF104189, USF108437), University of Tennessee Health Science Center (16–04626-FB), Washington University School of Medicine (201610032), Huntsman Cancer Institute (IRB_00077147), Cedars-Sinai Medical Center (Pro000464423, CR00012892), Fred Hutchinson Cancer Center (6407), and University of Heidelberg (300/2001, S-134/2016).

Consent to participate and publication

Informed consent to participate and to have de-identified and aggregate study data published was obtained from all individual participants included in this study.

Competing interests

Dr. Felder reports an advisory role for GSK and research funding from ViewRay and Natera. Dr. Cohen reports personal fees and grants from Pfizer and personal fees from Taiho, Bayer, Regeneron, Biomea, Eisai, Delcath, Isofol, and GSK. Dr. Gong reports advisory/consulting for Aveo, Basilea, Bayer, EMD Serono, Elsevier, Exelixis, HalioDx, Janssen, Pfizer, Inc, QED Therapeutics, Seagen, and Taiho. Dr. Jim reports grant funding from Kite Pharm and a consultant role for SBR Bioscience. Dr. Ulrich reports oversight over research funded by several pharmaceutical companies in her role as Cancer Center Director, but she has not received funding directly herself. The other authors have no competing interests to disclose.

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Laura B. Oswald and Amanda Bloomer contributed equally.

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Oswald, L.B., Bloomer, A., Li, X. et al. Functional quality of life among newly diagnosed young adult colorectal cancer survivors compared to older adults: results from the ColoCare Study. Support Care Cancer 32, 298 (2024). https://doi.org/10.1007/s00520-024-08511-5

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