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

Cummings, Amanda; Grimmett, Chloe; Calman, Lynn; Patel, Mubarak; Permyakova, Natalia Vadimovna; Winter, Jane; Corner, Jessica; Din, Amy; Fenlon, Deborah; Richardson, Alison; Smith, Peter W.; Foster, Claire

Authors

Amanda Cummings

Chloe Grimmett

Lynn Calman

Mubarak Patel

Natalia Vadimovna Permyakova

Jane Winter

Amy Din

Deborah Fenlon

Alison Richardson

Peter W. Smith

Claire Foster



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 wellbeing outcomes up to five years following surgery.
Methods: Prospective cohort study of 872 colorectal cancer patients recruited 2010-2012 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 wellbeing outcomes.
Results: At baseline, the mean age of participants was 68 years, with 60% male and 65% colon cancer. 32% had one 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 one 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 years’ 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 multi-professional management and tailored assessment and follow-up, may aid recovery of health and wellbeing recovery in these individuals.

Journal Article Type Article
Publication Date Aug 1, 2018
Journal Psycho-Oncology
Print ISSN 1057-9249
Publisher Wiley
Peer Reviewed Peer Reviewed
APA6 Citation Cummings, A., Grimmett, C., Calman, L., Patel, M., Permyakova, N. V., Winter, J., …Foster, C. (2018). Comorbidities are associated with poorer quality of life, functioning and worse symptoms in the 5 years following colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) cohort study. Psycho-Oncology, doi:10.1002/pon.4845. ISSN 1057-9249
DOI https://doi.org/10.1002/pon.4845
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.4845
Additional Information This is the peer reviewed version of the article, which has been published in final form at https://onlinelibrary.w...i/abs/10.1002/pon.4845. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

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