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.
