Health‐Related Quality of Life Among Long‐Term Survivors of Colorectal Cancer: A Population‐Based Study

Learning Objectives After completing this course, the reader will be able to: Compare quality of life in long‐term colorectal cancer survivors with quality of life in the general population. Identify cancer complications that affect quality of life in long‐term colorectal cancer survivors. This article is available for continuing medical education credit at CME.TheOncologist.com Background. The number of long‐term colorectal cancer survivors is increasing. Cancer and its treatment can cause physical and psychological complications, but little is known about how it impacts quality of life (QOL) over the long term—5, 10, and 15 years after diagnosis. Methods. Cancer survivors were randomly selected from three tumor registries in France, diagnosed in 1990 (±1 year), 1995 (±1 year), and 2000 (±1 year). Controls were randomly selected from electoral rolls, stratifying on gender, age group, and residence area. Participants completed two QOL questionnaires, a fatigue questionnaire, an anxiety questionnaire, and a life conditions questionnaire. An analysis of variance was used to compare QOL scores of cancer survivors by period of diagnosis (5, 10, and 15 years) with those of controls, adjusted for sociodemographic data and comorbidities. Results. We included 344 colon cancer and 198 rectal cancer survivors and 1,181 controls. In a global analysis, survivors reported a statistically and clinically significant lower score in social functioning 5 years after diagnosis and higher scores in diarrhea symptoms 5 and 10 years after diagnosis. In subgroup analyses, rectal cancer affected QOL in the physical dimensions at 5 years and in the fatigue dimensions at 5 and 10 years. Conclusion. Survivors of colorectal cancer may experience the effects of cancer and its treatment up to 10 years after diagnosis, particularly for rectal cancer. Clinicians, psychologists, and social workers must pay special attention to rectal cancer survivors to improve overall management. 摘要 背景 结直肠癌长期幸存者的数量与日俱增。癌症及其治疗可引发生理上与心理上的并发症，但对确诊后长期‐‐5、10、15年生活质量（QOL）的影响却知之甚少。 方法 从法国3所肿瘤登记处随机化选择癌症幸存者，这些患者确诊时间为1990年（±1年）、1995年（±1年）、2000年（±1年）。从选民名册中随机化选择对照组病例，根据性别、年龄组以及居住区域进行分层。参与者完成2份QOL问卷、1份疲劳问卷、1份焦虑问卷以及1份生活条件问卷。经社会人口学数据与共病情况校正后，通过方差分析比较癌症幸存者与对照组在各个诊断期（5、10、15年）的QOL评分。 结果 本研究入组了344例结肠癌、198例直肠癌幸存者以及1181例对照病例。全局分析显示，幸存者确诊后5年时的社会功能评分显著低于对照组，而确诊后5年与10年时的腹泻症状评分则显著高于对照组，且以上评分均具有统计学意义与临床意义。亚组分析显示，直肠癌于5年时在生理维度、5年与10年时在疲倦维度对QOL具有影响。 结论 结直肠癌，尤其是直肠癌幸存者可能在确诊后长达10年内经受癌症及其治疗的影响。为全面改善直肠癌幸存者的管理状况，临床医生、心理医生以及社会工作者必须对这部分患者