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. 2018 Oct;27(10):2427-2435.
doi: 10.1002/pon.4845. Epub 2018 Sep 13.

Comorbidities are associated with poorer quality of life and functioning and worse symptoms in the 5 years following colorectal cancer surgery: Results from the ColoREctal Well-being (CREW) cohort study

Amanda Cummings  1 , Chloe Grimmett  1 , Lynn Calman  1 , Mubarak Patel  1 , Natalia Vadimovna Permyakova  1   2 , Jane Winter  1   3 , Jessica Corner  4 , Amy Din  1 , Deborah Fenlon  5 , Alison Richardson  3   6 , Peter W Smith  2 ; Members of CREW Study Advisory Committee; Claire Foster  1
Affiliations

Comorbidities are associated with poorer quality of life and functioning and worse symptoms in the 5 years following colorectal cancer surgery: Results from the ColoREctal Well-being (CREW) cohort study

Amanda Cummings et al. Psychooncology. 2018 Oct.

Abstract

Objective: More people are living with the consequences of cancer and comorbidity. We describe frequencies of comorbidities in a colorectal cancer cohort and associations with health and well-being outcomes up to 5 years following surgery.

Methods: Prospective cohort study of 872 colorectal cancer patients recruited 2010 to 2012 from 29 UK centres, awaiting curative intent surgery. Questionnaires administered at baseline (pre-surgery), 3, 9, 15, 24 months, and annually up to 5 years. Comorbidities (and whether they limit activities) were self-reported by participants from 3 months. The EORTC QLQ-C30 and QLQ-CR29 assessed global health/quality of life (QoL), symptoms, and functioning. Longitudinal analyses investigated associations between comorbidities and health and well-being outcomes.

Results: At baseline, the mean age of participants was 68 years, with 60% male and 65% colon cancer. Thirty-two per cent had 1 and 40% had ≥2 comorbidities. The most common comorbidities were high blood pressure (43%), arthritis/rheumatism (32%), and anxiety/depression (18%). Of those with comorbidities, 37% reported at least 1 that limited their daily activities. Reporting any limiting comorbidities was associated with poorer global health/QoL, worse symptoms, and poorer functioning on all domains over 5-year follow-up. Controlling for the most common individual comorbidities, depression/anxiety had the greatest deleterious effect on outcomes.

Conclusions: Clinical assessment should prioritise patient-reported comorbidities and whether these comorbidities limit daily activities, as important determinants of recovery of QoL, symptoms, and functioning following colorectal cancer. Targeted interventions and support services, including multiprofessional management and tailored assessment and follow-up, may aid recovery of health and well-being in these individuals.

Keywords: cancer; colorectal cancer; comorbidities; health and well-being; longitudinal; oncology; quality of life; survivorship.

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Figures

Figure 1
Figure 1
Self‐report comorbidity section of CREW questionnaires
See this image and copyright information in PMC

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