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Quality of Life in Patients With Colorectal Cancer 1 Year After Diagnosis Compared With the General Population: A Population-Based Study

From the German Centre for Research on Aging, Department of Epidemiology, Heidelberg, Germany; University of Ulm, Department of Epidemiology, Ulm, Germany; Saarland Cancer Registry, Saarbrücken, Germany.

Address reprint requests to Volker Arndt, MD, MPH, Department of Epidemiology, German Centre for Research on Ageing, Bergheimer Strasse 20, D-69115 Heidelberg, Germany; e-mail: arndt{at}dzfa.uni-heidelberg.de

PURPOSE: Quality of life (QOL) has become an important outcome measure for patients with cancer, but long-term results from population-based studies are rare. The objective of our study was to identify specific limitations of QOL in survivors of colorectal cancer in comparison with men and women from the general population 1 year after diagnosis when acute treatment effects are expected to have declined.

PATIENTS AND METHODS: QOL was assessed 1 year after diagnosis in a population-based cohort of 439 patients with colorectal cancer from Saarland (Germany) using the EORTC-QLC30 questionnaire. Specific functional and symptom QOL scores were compared with published reference data from the general population.

RESULTS: Of 439 patients, 378 of them survived the first year after tumor diagnosis (86.1%). Of these, 309 returned the questionnaire (response rate, 81.7%). Compared with the general population, colorectal cancer patients scored their physical, role, cognitive, and global health functioning only slightly worse. More severe limitations were observed for the emotional and social functioning scales and for the symptom subscales of fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties. The differences regarding functional and symptom scores were predominantly found in younger age groups whereas older cancer patients and controls rated their health and QOL similarly.

CONCLUSION: Deficits in emotional and social functioning and specific limitations like fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties are main factors hampering the QOL among colorectal cancer patients and seem to affect predominantly younger patients.

This study was supported by two grants of the German Cancer Foundation (Deutsche Krebshilfe), Project No. 70-1816, 70-2413.

Presented in part at the 24th Annual Meeting of the International Association of Cancer Registries, Tampere, Finland, June 25-27, 2002.

V.A. and H.M. equally contributed to the manuscript.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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