gms | German Medical Science

Introduction: Research on quality of life of colorectal cancer survivors has mainly focused on downsides of cancer survivorship like long-term symptoms and restrictions in quality of life. But studies have shown that a high percentage of cancer survivors also report positive changes in the context of their disease. As no study has investigated benefit finding (BF) and posttraumatic growth (PTG) in long-term (≥ 5 years past diagnosis) colorectal cancer survivors, the aim of this study is to investigate the prevalence and determinants of BF and PTG in this survivor group and to assess the correlation between these constructs and quality of life.

Material and Methods: The analysis was based on data of a population-based cohort from the Rhine-Neckar-Odenwald region including 906 patients with a diagnosis of stage I to stage IV colorectal cancer in 2003 or 2004 (DACHS study). Five years after diagnosis, 483 out of 561 eligible survivors (86%) responded to a mailed follow-up survey that included the benefit finding scale, the posttraumatic growth inventory, and the cancer-specific quality of life questionnaire of the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30). Prevalence of BF and PTG, determinants of moderate to high BF and PTG, and the association between BF, PTG, and quality of life were investigated.

Results: Moderate to high levels of BF and PTG were experienced by 64% and 46% of the survivors, respectively. Domains with the highest prevalence of moderate to high growth were appreciation of life (70%) and acceptance (62%). Education was the only socio-demographic variable that was significantly associated with BF and PTG. Survivors with the highest level of education reported less BF and PTG. Lower BF and PTG levels were also associated with higher depression scores. PTG increased with increasing stage and self-reported burden of diagnosis. Quality of life only correlated weakly with PTG (Pearson’s r=0.1180, P=0.0112) and not with BF (r=0.0537, P=0.2456).

Discussion / Conclusion: Many long-term colorectal cancer survivors experience BF and PTG. As these constructs were not strongly correlated with quality of life, focusing solely on quality of life after cancer misses an important aspect of survivorship.

Funding: This study was funded by the IMPACT project (Improving long-term prognosis and quality of life of patients with colorectal cancer), a project within the funding program on 'Long-term investigations in health research' of the German Federal Ministry of Education and Research (grant no. 01 ER 0814).