gms | German Medical Science

Introduction: Quality of Life (QoL) is an important outcome measure in oncology, in particular with regard to progressed stages of the disease were therapy is mainly palliative. The aim of this study was to assess QoL in younger patients with colorectal cancer.

Materials and Methods: In the course of the molecular genetic study ‘PopGen: Genetic risk factors of colon cancer’, which was conducted in cooperation with the Institut für Klinische Molekularbiologie (UK S-H Campus Kiel) patients with colorectal cancer (ICD-10 diagnosis C18-C21, age at diagnosis <65 yrs, diagnosis between 01/2000 and 09/2004, residents of Schleswig-Holstein) received a postal questionnaire (regarding medical care and quality of life; EORTC QLQ-C30). Eligible PopGen participants were identified in the epidemiological population based cancer registry of Schleswig-Holstein.

Results: In total, 245 patients provided a complemented questionnaire, of those 50.8% had tumors located in the colon (39.2% in the rectum). Most patients had extended tumors (T3 55.1%, T4 10.6%) and 40.8% were node positive. About 97% of the patients have been operated, 31.7% received an adjuvant radiation and 36.3% received chemotherapy.

The global health status was 67.0 + 24.8 (no stat. sig. gender difference). In the QLQ-C30 the lowest scores (low QoL) were measured for ‘role, emotional and social functioning’. Most impairments (high scores) were assessed regarding ‘fatigue’ and ‘insomnia’. Statistically significant differences between males and females were computed for ‘social functioning’ (M: 70.3, F: 73.4 ; p=0.016) and ‘insomnia’ (M: 25.7, F: 40.9; p=0.001).

A binary logistic regression model was computed to identify explanatory variables regarding quality of life (Explanatory variables: age, sex, education, spatial category, spouse, T-, N-, M-status, radiation, chemotherapy, anus praetor, discomfort, complications/undesired side effects of the therapy). However, ascending age (RR: 0.92, 95%CI: 0.87; 0.97) and having a private health insurance (RR: 0.23, 95%CI: 0.05; 0.95) were associated with a lower risk, while patients with an adjuvant radiation showed a higher risk (RR: 2.82, 95%CI: 1.44; 5.51) of an overall low global health status (QoL <66.7).

Discussion: QoL in young patients with colorectal cancer from Schleswig-Holstein was comparable to the age adjusted general population of Germany (males: 68.9; females: 67.3). Contrary to studies with older colorectal patients, in younger patients (<65 yrs) QoL rose with increasing age.