Counseling, Targeted Interventions Needed to Improve Health-Related Quality of Life in Young Colon Cancer Survivors

Data presented at the 2021 American Society of Clinical Oncology Gastrointestinal Cancers Symposium demonstrated that as the incidence of colorectal cancer in patients under 50-years-old increases, overall health-related quality of life among younger survivors is poorer, with their social and functional well-being suffering more as treatment duration grows longer.

Using the Functional Assessment of Cancer Therapy (FACT-C) survey, which assesses health-related quality of life (HRQoL) globally, along with a cross-sectional online survey for a CRC-specific scale that looked at emotional, physical, social, and functional well-being domains, researchers evaluated the responses of 235 patients with colorectal cancer (CRC) and found an overall low score of HRQoL of 67.3 out of a possible 136 in this patient population.

The mean age of the sample was 33.76 years old and the location of the patients’ tumors were either in the colon (41.7%) or rectum (58.3%). The majority of patients (33.23%) were diagnosed with stage 2 cancer and 98% were non-metastatic, while 42% experienced relapse of their disease. One hundred and eighty-nine patients (61.4%) were six to 18 months from their diagnosis or relapse, but important demographic figures like age and ethnicity did not have a significant statistical difference between the two groups.

Patients were split into two categories of six to 18 months from their initial diagnosis or relapse, and 19 to 36 months from diagnosis or relapse. While researchers did not find a significant difference between the two groups in terms of emotional and physical well-being, scores were low across all domains, with social well-being the highest (15.15/28) and emotional well-being the lowest (11.44/24). Moreover, functional well-being rated close to the bottom (11.84/28), with physical well-being the second highest (15.15/28).

Higher scores for physical and emotional well-being were observed in patients who had a longer time between diagnosis compared to short-term, whereas significantly lower scores were observed in social well-being for patients who had a shorter time between their diagnosis and the survey, at 15.24/28 versus 14/28 respectively. This was also observed in functional well-being, which scored at 13.2 for the six to 18-month group versus 11.12 for the 19 to 36-month group.

The researchers concluded that with the overall low HRQoL scores for young CRC survivors in the categories of social and functional well-being should be targeted by appropriate methods, as they were the lowest. These methods would include counseling and quality of life interventions, but further study into which of these methods would be best is needed.