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

Abstract

© 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd. 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 well-being outcomes up to 5years following surgery. Methods: Prospective cohort study of 872 colorectal cancer patients recruited 2010 to 2012 from 29 UK centres, awaiting curative intent surgery. Questionnaires administered at baseline (pre-surgery), 3, 9, 15, 24months, and annually up to 5years. Comorbidities (and whether they limit activities) were self-reported by participants from 3months. 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 well-being outcomes. Results: At baseline, the mean age of participants was 68years, with 60% male and 65% colon cancer. Thirty-two per cent had 1 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 1 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-year 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 multiprofessional management and tailored assessment and follow-up, may aid recovery of health and well-being in these individuals.

Citation

Cummings, A., Grimmett, C., Calman, L., Patel, M., Permyakova, N. V., Winter, J., Corner, J., Din, A., Fenlon, D., Richardson, A., Smith, P. W., & 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, 27(10), 2427-2435. https://doi.org/10.1002/pon.4845

• Journal Article Type: Article
• Acceptance Date: Jul 19, 2018
• Online Publication Date: Aug 1, 2018
• Publication Date: Oct 1, 2018
• Deposit Date: Aug 24, 2018
• Publicly Available Date: Aug 2, 2019
• Journal: Psycho-Oncology
• Print ISSN: 1057-9249
• Electronic ISSN: 1099-1611
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 10
• Pages: 2427-2435
• DOI: https://doi.org/10.1002/pon.4845
• Keywords: cancer, colorectal cancer, comorbidities, health and well-being, longitudinal, oncology, quality of life, survivorship
• Public URL: https://nottingham-repository.worktribe.com/output/1047115
• 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.wiley.com/doi/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.
• Contract Date: Aug 24, 2018