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Observational Study
. 2024 Apr 19;32(5):298.
doi: 10.1007/s00520-024-08511-5.

Functional quality of life among newly diagnosed young adult colorectal cancer survivors compared to older adults: results from the ColoCare Study

Laura B Oswald  1 , Amanda Bloomer  2 , Xiaoyin Li  2 , Esther Jean-Baptiste  2 , Gillian Trujillo  2 , Seth Felder  2 , Brent J Small  3 , Jennifer Ose  4   5   6 , Sheetal Hardikar  4   5 , Ildiko Strehli  4 , Lyen C Huang  4   5 , Kathi Mooney  4   5 , Matthew G Mutch  6 , Dante Chao  7   8 , Stacey A Cohen  9 , Meghana Karchi  10 , Elizabeth H Wood  10 , Victoria Damerell  11 , Nicole C Loroña  12 , Jun Gong  12 , Adetunji T Toriola  7   8 , Christopher I Li  9 , David Shibata  10 , Martin Schneider  11 , Biljana Gigic  11 , Jane C Figueiredo  12 , Heather S L Jim  2 , Cornelia M Ulrich  4   5 , Erin M Siegel  2
Affiliations
Observational Study

Functional quality of life among newly diagnosed young adult colorectal cancer survivors compared to older adults: results from the ColoCare Study

Laura B Oswald et al. Support Care Cancer. .

Abstract

Purpose: Colorectal cancer (CRC) incidence and mortality are increasing among young adults (YAs) aged 18-39. This study compared quality of life (QOL) between YA and older adult CRC survivors in the ColoCare Study.

Methods: Participants were grouped by age (years) as follows: 18-39 (YA), 40-49, 50-64, and 65 + . Functional QOL (physical, social, role, emotional, cognitive) and global QOL were assessed with the EORTC-QLQ-C30 at enrollment, 3, 6, and 12 months. Average scores were compared between groups over time using longitudinal mixed-effect modeling. Proportions with clinically meaningful QOL impairment were calculated using age-relevant thresholds and compared between groups over time using logistic regression with mixed effects.

Results: Participants (N = 1590) were n = 81 YAs, n = 196 aged 40-49, n = 627 aged 50-64, and n = 686 aged 65 + . Average physical function was better among YAs than participants aged 50-64 (p = 0.010) and 65 + (p < 0.001), and average social function was worse among YAs than aged 65 + (p = 0.046). Relative to YAs, all age groups were less likely to report clinically meaningful social dysfunction (aged 40-49 OR = 0.13, 95%CI = 0.06-0.29; aged 50-64 OR = 0.10, 95%CI = 0.05-0.21; aged 65 + OR = 0.07, 95%CI = 0.04-0.15) and role dysfunction (aged 40-49 OR = 0.36, 95%CI = 0.18-0.75; aged 50-64 OR = 0.41, 95%CI = 0.22-0.78; aged 65 + OR = 0.32, 95%CI = 0.17-0.61). Participants aged 40-49 were also less likely to report physical dysfunction (OR = 0.42, 95%CI = 0.19-0.93).

Conclusion: YA CRC survivors reported better physical and worse social function compared to older CRC survivors, and YA CRC survivors were more likely to report clinically meaningful social, role, and physical disfunction. Future work should further investigate QOL using age-relevant benchmarks to inform best practices for CRC survivorship care.

Trial registration: NCT02328677, registered December 2014.

Keywords: Cancer survivors; Colorectal cancer; Patient-reported outcomes; Quality of life; Young adult.

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Conflict of interest statement

Competing interests: Dr. Felder reports an advisory role for GSK and research funding from ViewRay and Natera. Dr. Cohen reports personal fees and grants from Pfizer and personal fees from Taiho, Bayer, Regeneron, Biomea, Eisai, Delcath, Isofol, and GSK. Dr. Gong reports advisory/consulting for Aveo, Basilea, Bayer, EMD Serono, Elsevier, Exelixis, HalioDx, Janssen, Pfizer, Inc, QED Therapeutics, Seagen, and Taiho. Dr. Jim reports grant funding from Kite Pharm and a consultant role for SBR Bioscience. Dr. Ulrich reports oversight over research funded by several pharmaceutical companies in her role as Cancer Center Director, but she has not received funding directly herself. The other authors have no competing interests to disclose.

Figures

Figure 1.
Figure 1.
Bar graphs showing the proportion of participants reporting clinically meaningful QOL dysfunction/impairment by age group at each timepoint. Noted group differences represent results of chi-square analyses with *p<0.05, **p<0.01, ***p<0.001.
See this image and copyright information in PMC

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