Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study
Abstract Background The group of colorectal cancer (CRC) survivors continues to grow worldwide. Understanding health-related quality of life (HRQOL) determinants and consequences of HRQOL impairments in long-term CRC survivors may help to individualize survivorship care plans. We aimed to i) examine...
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doaj-f766ea3e5f524f8fbcfee06d5b4584e22020-11-25T02:21:20ZengBMCBMC Cancer1471-24072018-11-0118111510.1186/s12885-018-5075-1Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort studyIlka Ratjen0Clemens Schafmayer1Janna Enderle2Romina di Giuseppe3Sabina Waniek4Manja Koch5Greta Burmeister6Ute Nöthlings7Jochen Hampe8Sabrina Schlesinger9Wolfgang Lieb10Institute of Epidemiology, University of Kiel, University Hospital Schleswig-HolsteinDepartment of General and Thoracic Surgery, University Hospital Schleswig-HolsteinInstitute of Epidemiology, University of Kiel, University Hospital Schleswig-HolsteinInstitute of Epidemiology, University of Kiel, University Hospital Schleswig-HolsteinInstitute of Epidemiology, University of Kiel, University Hospital Schleswig-HolsteinDepartment of Nutrition, Harvard T.H. Chan School of Public HealthDepartment of General and Thoracic Surgery, University Hospital Schleswig-HolsteinNutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University BonnMedical Department 1, University Hospital Dresden, Technical University DresdenInstitute of Biometrics and Epidemiology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes ResearchInstitute of Epidemiology, University of Kiel, University Hospital Schleswig-HolsteinAbstract Background The group of colorectal cancer (CRC) survivors continues to grow worldwide. Understanding health-related quality of life (HRQOL) determinants and consequences of HRQOL impairments in long-term CRC survivors may help to individualize survivorship care plans. We aimed to i) examine the HRQOL status of CRC long-term survivors, ii) identify cross-sectional sociodemographic and clinical correlates of HRQOL, and iii) investigate the prospective association of HRQOL after CRC diagnosis with all-cause mortality. Methods We assessed HRQOL within a Northern German cohort of 1294 CRC survivors at a median of 6 years after CRC diagnosis using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Cross-sectional correlates of different HRQOL dimensions were analyzed using multivariable-adjusted logistic regression models with HRQOL as a binary variable. With multivariable-adjusted Cox proportional hazards regression models, hazard ratios (HR) of all-cause mortality were estimated per 10-point-increments of an HRQOL summary score, a global quality of life scale, and HRQOL functioning and symptom domains. Results The median HRQOL summary score was 87 (interquartile range: 75–94). Sex, age, education, tumor location, metastases, other cancers, type of therapy, and current stoma were identified as correlates of different HRQOL scales. After a median follow-up time of 7 years after HRQOL assessment, 175 participants had died. Nearly all HRQOL domains, except for cognitive functioning and diarrhea, were significantly associated with all-cause mortality. A 10-point-increment in the summary score decreased the risk of death by 24% (HR: 0.76; 95% CI: 0.70–0.82). Conclusions HRQOL in CRC survivors appeared to be relatively high in the long term. Various clinical and sociodemographic factors were cross-sectionally associated with HRQOL in long-term CRC survivors. Lower HRQOL was associated with increased all-cause mortality. Individualized healthcare programs for CRC survivors (including psychosocial screening and interventions) are needed to detect decreased HRQOL and to further improve long-term HRQOL and survival.http://link.springer.com/article/10.1186/s12885-018-5075-1Health-related quality of lifeLong-term survivorsColorectal cancerCorrelatesMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ilka Ratjen Clemens Schafmayer Janna Enderle Romina di Giuseppe Sabina Waniek Manja Koch Greta Burmeister Ute Nöthlings Jochen Hampe Sabrina Schlesinger Wolfgang Lieb |
spellingShingle |
Ilka Ratjen Clemens Schafmayer Janna Enderle Romina di Giuseppe Sabina Waniek Manja Koch Greta Burmeister Ute Nöthlings Jochen Hampe Sabrina Schlesinger Wolfgang Lieb Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study BMC Cancer Health-related quality of life Long-term survivors Colorectal cancer Correlates Mortality |
author_facet |
Ilka Ratjen Clemens Schafmayer Janna Enderle Romina di Giuseppe Sabina Waniek Manja Koch Greta Burmeister Ute Nöthlings Jochen Hampe Sabrina Schlesinger Wolfgang Lieb |
author_sort |
Ilka Ratjen |
title |
Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study |
title_short |
Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study |
title_full |
Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study |
title_fullStr |
Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study |
title_full_unstemmed |
Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study |
title_sort |
health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a german cohort study |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2018-11-01 |
description |
Abstract Background The group of colorectal cancer (CRC) survivors continues to grow worldwide. Understanding health-related quality of life (HRQOL) determinants and consequences of HRQOL impairments in long-term CRC survivors may help to individualize survivorship care plans. We aimed to i) examine the HRQOL status of CRC long-term survivors, ii) identify cross-sectional sociodemographic and clinical correlates of HRQOL, and iii) investigate the prospective association of HRQOL after CRC diagnosis with all-cause mortality. Methods We assessed HRQOL within a Northern German cohort of 1294 CRC survivors at a median of 6 years after CRC diagnosis using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Cross-sectional correlates of different HRQOL dimensions were analyzed using multivariable-adjusted logistic regression models with HRQOL as a binary variable. With multivariable-adjusted Cox proportional hazards regression models, hazard ratios (HR) of all-cause mortality were estimated per 10-point-increments of an HRQOL summary score, a global quality of life scale, and HRQOL functioning and symptom domains. Results The median HRQOL summary score was 87 (interquartile range: 75–94). Sex, age, education, tumor location, metastases, other cancers, type of therapy, and current stoma were identified as correlates of different HRQOL scales. After a median follow-up time of 7 years after HRQOL assessment, 175 participants had died. Nearly all HRQOL domains, except for cognitive functioning and diarrhea, were significantly associated with all-cause mortality. A 10-point-increment in the summary score decreased the risk of death by 24% (HR: 0.76; 95% CI: 0.70–0.82). Conclusions HRQOL in CRC survivors appeared to be relatively high in the long term. Various clinical and sociodemographic factors were cross-sectionally associated with HRQOL in long-term CRC survivors. Lower HRQOL was associated with increased all-cause mortality. Individualized healthcare programs for CRC survivors (including psychosocial screening and interventions) are needed to detect decreased HRQOL and to further improve long-term HRQOL and survival. |
topic |
Health-related quality of life Long-term survivors Colorectal cancer Correlates Mortality |
url |
http://link.springer.com/article/10.1186/s12885-018-5075-1 |
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