Risk factors for poor health-related quality of life in patients with colon cancer include stoma and smoking habits

Catarina Tiselius, Andreas Rosenblad, Eva Strand, Kenneth Smedh, Catarina Tiselius, Andreas Rosenblad, Eva Strand, Kenneth Smedh

Abstract

Background: Previous studies have shown that health-related quality of life (HRQoL) is associated with the prognosis of cancer patients. The aim of this study was to investigate risk factors for poor HRQoL in patients with colon cancer.

Methods: This was a prospective population-based study of patients with colon cancer included between 2012 and 2016. HRQoL was measured using the cancer-specific European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. Multiple linear regression analysis adjusted for age, sex, body mass index, smoking habits, American Society of Anesthesiologists physical status classification, emergency/elective surgery, resection with/without a stoma and tumour stage was used.

Results: A total of 67% (376/561) of all incident patients with colon cancer (196 [52.1%] females) was included. Mean (range) age was 73 (30-96) years. Patients with worse health (American Society of Anesthesiologists physical status 3 and 4), those with higher body mass index, smokers and those planned to undergo surgical treatment with a stoma were at a higher risk for poor HRQoL than the other included patients at baseline and 6-month follow-up.

Conclusions: Patient characteristics such as smoking, high body mass index and worse physical health as well as treatment with a stoma were associated with lower HRQoL. Health care for such patients should focus on social and lifestyle behavioural support and stoma closure, when possible.

Trial registration: ClinicalTrials.gov (NCT03910894).

Keywords: Colon cancer; Health-related quality of life; Risk factors; Smoking; Stoma.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart of study patients diagnosed with colon cancer at baseline and at the 6-month follow-up

References

    1. West NP, Hohenberger W, Weber K, et al. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol. 2010;28(2):272–278. doi: 10.1200/JCO.2009.24.1448.
    1. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014;26(383):1490–1502. doi: 10.1016/S0140-6736(13)61649-9.
    1. World Health Organization. WHOQOL: measuring quality of life, the World Health Organization quality of life instruments (The WHOQOL-100 and the WHOQOL-BREF) . Accessed 1999.
    1. Aaronson NK, Ahmedzai S, Bergman B, et al. 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. 1993;85:365–376. doi: 10.1093/jnci/85.5.365.
    1. Marventano S, Forjaz M, Grosso G, et al. Health related quality of life in colorectal cancer patients: state of the art. BMC Surg. 2013;13(Suppl 2):S15. doi: 10.1186/1471-2482-13-S2-S15.
    1. Schlesinger S, Walter J, Hampe J, et al. Lifestyle factors and health-related quality of life in colorectal cancer survivors. Cancer Causes Control. 2014;25:99–110. doi: 10.1007/s10552-013-0313-y.
    1. Färkkilä N, Torvinen S, Roine RP, et al. Health-related quality of life among breast, prostate, and colorectal cancer patients with end-stage disease. Qual Life Res. 2014;23:1387–1394. doi: 10.1007/s11136-013-0562-y.
    1. Jansen L, Herrmann A, Stegmaier C, et al. Health-related quality of life during the 10 years after diagnosis of colorectal cancer: a population-based study. J Clin Oncol. 2011;29:3263–3269. doi: 10.1200/JCO.2010.31.4013.
    1. Verhaar S, Vissers PA, Maas H, et al. Treatment-related differences in health related quality of life and disease specific symptoms among colon cancer survivors: results from the population-based PROFILES registry. Eur J Cancer. 2015;51:1263–1273. doi: 10.1016/j.ejca.2015.04.004.
    1. Willems RA, Bolman CA, Mesters I, et al. Cancer survivors in the first year after treatment: the prevalence and correlates of unmet needs in different domains. Psychooncology. 2016;25:51–57. doi: 10.1002/pon.3870.
    1. Asplund D, Bisgaard T, Bock D, et al. Pretreatment quality of life in patients with rectal cancer is associated with intrusive thoughts and sense of coherence. Int J Colorectal Dis. 2017;32:1639–1647. doi: 10.1007/s00384-017-2900-y.
    1. Michelson H, Bolund C, Nilsson B, et al. Health-related quality of life measured by the EORTC QLQ-C30–reference values from a large sample of Swedish population. Acta Oncol. 2000;39:477–484. doi: 10.1080/028418600750013384.
    1. Statistics Sweden. Statistics of the Swedish population; 2008. .
    1. Fayers PM. Interpreting quality of life data: population-based reference data for the EORTC QLQ-C30. Eur J Cancer. 2001;37:1331–1334. doi: 10.1016/S0959-8049(01)00127-7.
    1. Fayers PM, Aaronson NK, Bjordal K, et al: on behalf of the EORTC Quality of Life Group. The EORTC QLQ-C30 Scoring Manual. 3rd ed. Brussels: European Organisation for Research and Treatment of Cancer. 2001.
    1. Osoba D, Bezjak A, Brundage M, et al. Quality of life committee of the NCIC CTG Analysis and interpretation of health-related quality-of-life data from clinical trials: basic approach of The National Cancer Institute of Canada Clinical Trials Group. Eur J Cancer. 2005;41:280–287. doi: 10.1016/j.ejca.2004.10.017.
    1. Wong CK, Guo VY, Chen J, et al. Methodological and reporting quality of comparative studies evaluating health-related quality of life of colorectal cancer patients and controls: a systematic review. Dis Colon Rectum. 2016;59:1073–1086. doi: 10.1097/DCR.0000000000000618.
    1. Färkkilä N, Sintonen H, Saarto T, et al. Health-related quality of life in colorectal cancer. Colorectal Dis. 2013;15:e215–e222. doi: 10.1111/codi.12143.
    1. Janson M, Lindholm E, Anderberg B, et al. Randomized trial of health-related quality of life after open and laparoscopic surgery for colon cancer. Surg Endosc. 2007;21:747–753. doi: 10.1007/s00464-007-9217-9.
    1. Herrle F, Sandra-Petrescu F, Weiss C, et al. Quality of life and timing of stoma closure in patients with rectal cancer undergoing low anterior resection with diverting stoma: a multicenter longitudinal observational study. Dis Colon Rectum. 2016;59:281–290. doi: 10.1097/DCR.0000000000000545.
    1. Wrenn SM, Cepeda-Benito A, Ramos-Valadez DI, et al. Patient perceptions and quality of life after colon and rectal surgery: What do patients really want? Dis Colon Rectum. 2018;61:971–978. doi: 10.1097/DCR.0000000000001078.
    1. Arndt V, Merx H, Stegmaier C et al. Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol. 2004; 22:4829–236. Erratum in: J Clin Oncol. 2005;23(1):248.
    1. Vissers PA, Thong MS, Pouwer F, et al. The impact of comorbidity on health-related quality of life among cancer survivors: analyses of data from the PROFILES registry. J Cancer Surviv. 2013;7:602–613. doi: 10.1007/s11764-013-0299-1.
    1. Arndt V, Stegmaier C, Ziegler H, et al. A population-based study of the impact of specific symptoms on quality of life in women with breast cancer 1 year after diagnosis. Cancer. 2006;107:2496–2503. doi: 10.1002/cncr.22274.
    1. Vissers PA, Thong MS, Pouwer F, et al. Prospectively measured lifestyle factors and BMI explain differences in health-related quality of life between colorectal cancer patients with and without comorbid diabetes. Support Care Cancer. 2016;24:2591–2601. doi: 10.1007/s00520-015-3052-7.
    1. Mody RR, Smith MJ. Smoking status and health-related quality of life: as findings from the 2001 behavioral risk factor surveillance system data. Am J Health Promot. 2006;20:251–258. doi: 10.4278/0890-1171-20.4.251.
    1. Jang S, Prizment A, Haddad T, et al. Smoking and quality of life among female survivors of breast, colorectal and endometrial cancers in a prospective cohort study. J Cancer Surviv. 2011;5:115–122. doi: 10.1007/s11764-010-0147-5.
    1. Tseng TS, Lin HY, Martin MY, et al. Disparities in smoking and cessation status among cancer survivors and non-cancer individuals: a population-based study from National Health and Nutrition Examination Survey. J Cancer Surviv. 2010;4:313–321. doi: 10.1007/s11764-010-0127-9.
    1. Deshields TL, Potter P, Olsen S, et al. The persistence of symptom burden: symptom experience and quality of life of cancer patients across one year. Support Care Cancer. 2014;22:1089–1096. doi: 10.1007/s00520-013-2049-3.
    1. Siassi M, Weiss M, Hohenberger W, et al. Personality rather than clinical variables determines quality of life after major colorectal surgery. Dis Colon Rectum. 2009;52(4):662–668. doi: 10.1007/DCR.0b013e31819ecf2e.
    1. Tantoy IY, Cooper BA, Dhruva A, et al. Quality of life of patients with gastrointestinal cancers undergoing chemotherapy. Qual Life Res. 2018;27:1865–1876. doi: 10.1007/s11136-018-1860-1.
    1. Bouvier AM, Jooste V, Bonnetain F, et al. Adjuvant treatments do not alter the quality of life in elderly patients with colorectal cancer: a population-based study. Cancer. 2008;113:879–886. doi: 10.1002/cncr.23629.
    1. Cheng KK, Lim EY, Kanesvaran R. Quality of life of elderly patients with solid tumours undergoing adjuvant cancer therapy: a systematic review. BMJ Open. 2018;8:e018101. doi: 10.1136/bmjopen-2017-018101.
    1. Downing A, Glaser AW, Finan PJ, et al. Functional outcomes and health-related quality of life after curative treatment for rectal cancer: a population-level study in England. Int J Radiat Oncol Biol Phys. 2019;103:1132–1142. doi: 10.1016/j.ijrobp.2018.12.005.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다