Anxiety, depression, health-related quality of life, and mortality among colorectal patients: 5-year follow-up

Support Care Cancer. 2022 Oct;30(10):7943-7954. doi: 10.1007/s00520-022-07177-1. Epub 2022 Jun 23.

Abstract

Purpose: Health-related quality of life (HRQoL) measurement represents an important outcome in cancer patients. We describe the evolution of HRQoL over a 5-year period in colorectal cancer patients, identifying predictors of change and how they relate to mortality.

Methods: Prospective observational cohort study including colorectal cancer (CRC) patients having undergone surgery in nineteen public hospitals who were monitored from their diagnosis, intervention and at 1-, 2-, 3-, and 5-year periods thereafter by gathering HRQoL data using the EuroQol-5D-5L (EQ-5D-5L), European Organization for Research and Treatment of Cancer's Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30), and Hospital Anxiety and Depression Scale (HADS) questionnaires. Multivariable generalized linear mixed models were used.

Results: Predictors of Euroqol-5D-5L (EQ-5D-5L) changes were having worse baseline HRQoL; being female; higher Charlson index score (more comorbidities); complications during admission and 1 month after surgery; having a stoma after surgery; and needing or being in receipt of social support at baseline. For EORTC-QLQ-C30, predictors of changes were worse baseline EORTC-QLQ-C30 score; being female; higher Charlson score; complications during admission and 1 month after admission; receiving adjuvant chemotherapy; and having a family history of CRC. Predictors of changes in HADS anxiety were being female and having received adjuvant chemotherapy. Greater depression was associated with greater baseline depression; being female; higher Charlson score; having complications 1 month after intervention; and having a stoma. A deterioration in all HRQoL questionnaires in the previous year was related to death in the following year.

Conclusions: These findings should enable preventive follow-up programs to be established for such patients in order to reduce their psychological distress and improve their HRQoL to as great an extent as possible.

Gov identifier: NCT02488161.

Keywords: Cohort studies; Colorectal cancer; Health-related quality of life; Longitudinal studies; Patient-reported outcome measures.

Publication types

  • Observational Study

MeSH terms

  • Anxiety / epidemiology
  • Anxiety / etiology
  • Anxiety / psychology
  • Colorectal Neoplasms* / psychology
  • Colorectal Neoplasms* / surgery
  • Depression / epidemiology
  • Depression / etiology
  • Depression / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Prospective Studies
  • Quality of Life* / psychology
  • Surveys and Questionnaires

Associated data

  • ClinicalTrials.gov/NCT02488161