Pattern of Health-Related Quality of Life and its Association among Patients with Colorectal Cancer

Abstract

Aim: Research on patient-reported outcomes in colorectal cancer are scarce in Malaysia. We aimed to determine pattern of health-related quality of life and its associations among patients with colorectal cancer.
Methods: A cross-sectional study of 324 patients. Data were drawn from patient’s records and interviews. Research tools included the locally validated European Organization for Research and Treatment of Cancer (EORTC) core QLQ-C30 and colorectal-cancer specific QLQ-CR29 questionnaires.
Results: The mean (±standard deviation) age of patients was 62.5 (±13.6) years. Majority of them were Chinese (62.3%) followed by Malays (19.8%), Indians (14.8%) and others (3.1%). Colon cancer was 7-fold more common than rectal cancer (87% vs 13%). Majority of them were presented at Stage II (29.6%) and III (28.1) of TNM Staging. The mean (±SD) score for global health status/quality of life (GHS/QOL) was 73.13 (±14.19). Good overall functionality (mean scores ≥80) was observed for physical, emotional, role, cognitive and social/family for QLQ-C30; body image, anxiety and weight for QLQ-CR29. The mean score for sexual functioning in men (32.95±28.81) and women (17.56±25.60) were low. Commonest symptoms were fatigue (22.29±17.40), urinary frequency (21.96 ± 24.22) and insomnia (18.42 ± 23.32). Those with lower GHS/QOL had stoma (p=0.044) and were of Chinese ethnicity (p<0.001). On multivariate analysis, ethnicity was the only independent predictor of GHS/QOL (95% confidence interval, 2.589 to 6.139, p<0.001).
Conclusion: Our results suggest that there is decrease in sexual functioning despite good overall GHS/QOL among our colorectal cancer survivors. Fatigue, sleep loss and urinary frequency were the common symptoms after cancer treatment. Chinese patients had the poorest quality of life.