Do long- and very long-term colorectal cancer survivors report quality of life comparable to cancer free controls? – A population-based study

Purpose:

Previous research suggests an age differential in health-related quality of life (HRQL) among long-term (5 – 10 years post-diagnosis, LTS) colorectal cancer (CRC) survivors. Few studies have specifically addressed the association of age differentials with HRQL for very long-term CRC survivors (> 10 years post-diagnosis, VLTS) and non-cancer controls. We aimed to assess possible deficits in HRQL of CRC-LTS and CRC-VLTS in comparison with age-matched non-cancer controls, and whether the observed pattern varies by age.

Methods:

We used data from the population-based CAncEr Survivorship – A multi-Regional (CAESAR+) study in collaboration with six German epidemiologic cancer registries. Cancer survivors diagnosed in 1994 – 2004 and aged 20 – 75 years at diagnosis completed a postal survey in 2009 – 2011. HRQL from a representative sample of population controls was accessed from the Lebensqualität in DEeutschland (LinDE) study conducted in 2013 – 2014. HRQL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Core-30 questionnaire. We compared least square means of HRQL scores between CRC survivors and population controls, stratified by age (< 65, 65 – 69, 70 – 74, 75 – 79, ≥80) and time since diagnosis. All analyses were adjusted for age, sex, and education, where appropriate.

Results:

In total, 1016 CRC-LTS, 471 CRC-VLTS and 1680 LinDe respondents were included in the analyses. CRC-LTS < 65 years reported poorer HRQL and higher symptom scores when compared with non-cancer controls of the same age strata. CRC-VLTS reported comparable HRQL to non-cancer controls in most age groups. Both CRC-LTS and CRC-VLTS have more complaints of constipation and diarrhea than controls regardless of age. Analyses stratified by sex and cancer site (colon/rectum) showed similar results.

Conclusions:

Although CRC survivors experience persistent detriments in HRQL many years after diagnosis, these effects are most felt among the younger CRC-LTS.