Artikel
Persistence of restrictions in quality of life over three years in patients with colorectal cancer: a population-based study
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Veröffentlicht: | 20. März 2006 |
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Background: With over 66 000 new cases each year colorectal cancer (CRC) is the most frequent malignancy among men and women in Germany. Due to advances in early diagnosis and therapy the prognosis of colorectal cancer has improved over the last decades and most people diagnosed with CRC today survive the disease. Despite the high burden and prevalence of colorectal cancer, there is only limited information from population-based studies regarding quality of life of patients who have survived beyond the first year past treatment.
Methods: Quality of life was assessed in a population-based cohort of 309 patients with colorectal cancer from Saarland (Germany) 1 and 3 years after diagnosis using the QLQ-C30 questionnaire and the tumor specific module CR-38. Of those who survived, 92% returned the questionnaire. Functional and symptom scores were compared internally and with reference data from the general population.
Results: Three years after diagnosis most colorectal cancer survivors reported high overall quality of life and only small deficits in physical functioning, but deficits in emotional and social functioning and specific limitations like fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties observed one year after diagnosis were found to persist. Younger patients continued to be more strongly affected by the physical and psychosocial sequelae of colorectal cancer even though they regained better than older patients. Overall, improvements in quality of life from the first to the third year after diagnosis were very modest and limited to improvements concerning financial difficulties, a better future perspective and fewer stoma related problems. This pattern persisted even after exclusion of 26 patients with colorectal cancer recurrence during the follow-up interval who showed substantial impairments for almost all function scales and all symptoms covered by the QLQ C-30 and the CR-38 questionnaire.
Conclusions: Although three years after diagnosis most colorectal cancer survivors report a high overall quality of life and only small deficits in physical functioning, the results of our study indicate that deficits in emotional and social functioning and specific limitations like fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties persist over years and affect predominantly younger patients.