Change Toward Healthier Lifestyles Is Associated With Better Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors

Abstract

Background: Little is known about how changes in a constellation of lifestyle factors affect health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. Our study aimed to investigate the association between changes in healthy lifestyle and HRQoL over time in survivors of stage I–IV CRC. Methods: We included 2,283 long-term (≥5 years postdiagnosis) survivors. A healthy lifestyle score (HLS) comprising smoking, alcohol consumption, diet, physical activity, and body fatness was derived at diagnosis and 5-year follow-up (5YFU) and categorized as low, moderate, or high. We assessed HRQoL with the EORTC Quality of Life Questionnaire-Core 30 at 5YFU and 10-year follow-up. We used multivariable linear regression and linear mixed models to explore associations between changes in HLS and HRQoL over follow-up. Results: A low baseline HLS was associated with poorer functioning and global health/QoL and a higher symptom burden at 5YFU compared with a high baseline HLS. An improved HLS from baseline to 5YFU was associated with better functioning, higher global health/QoL, and fewer symptoms at 5YFU than a maintained-high HLS. In longitudinal analyses, improved HLS was associated with better functioning at follow-up. Survivors with a maintained-high or an improved HLS reported generally less fatigue, pain, and dyspnea at follow-ups compared with survivors with a maintained-low or decreased HLS. Conclusions: Change toward a healthier lifestyle since diagnosis was associated with better HRQoL in long-term CRC survivors. Our results support the importance of maintaining and/or promoting a healthier lifestyle among CRC survivors postdiagnosis.

Fatigue, quality of life and associations with adherence to the World Cancer Research Fund guidelines for health behaviours in 5835 adults living with and beyond breast, prostate and colorectal cancer in England: A cross‐sectional study

“…Much of the previous research in this area has been cross‐sectional in nature, apart from a recent series of articles by Kenkhuis et al exploring longitudinal relationships among colorectal cancer survivors' post‐treatment adherence with WCRF and QoL, 27,28,57 which suggests that higher MVPA was longitudinally associated with higher QoL 28 . Furthermore, Eyl‐Armbruster et al found that positive changes in lifestyle behaviours (composite score) among colorectal cancer survivors' from baseline to 5 years was associated with better functioning and lower symptom burden at 5 years follow‐up 58 . Future prospective studies should seek to better understand the direction of these relationships in different groups of cancer survivors, and intervention studies should aim to explore whether adhering to these recommendations results in better patient QoL outcomes in the longer term.…”

“… 28 Furthermore, Eyl‐Armbruster et al found that positive changes in lifestyle behaviours (composite score) among colorectal cancer survivors' from baseline to 5 years was associated with better functioning and lower symptom burden at 5 years follow‐up. 58 Future prospective studies should seek to better understand the direction of these relationships in different groups of cancer survivors, and intervention studies should aim to explore whether adhering to these recommendations results in better patient QoL outcomes in the longer term.…”

Global status of research on gastrointestinal cancer patients’ quality of life: A bibliometric and visual analysis from 2003 to 2023

“…Taking the clusters of keywords co-occurrence, as well as the frequency and centrality of keywords into account, the research hotspots in this field were summarized as follows. Firstly, physical activity was a hot topic when exploring the effect of behavior changes on QoL for GI cancer survivors [ 23 , 45 , 46 ]. Moderate to intense PA has been demonstrated to be beneficial in improving the QoL of GI cancer survivors [ 47 , 48 ], but the health benefits of light PA were still uncertain.…”

“…A study demonstrated that 36 % of I ∼ III CRC survivors experienced moderate to high levels of psychological distress, and after a 2-year follow-up, 13 % of survivors still reported low QoL or high levels of psychological distress [ 57 ]. Besides, women, survivors with lower education levels, and symptoms of fatigue, sleep disorders, and pain were more likely to suffer from high levels of psychological distress [ 57 , 58 ], thus it is necessary to strengthen the health education [ 59 ] and lifestyle interventions [ 46 , 60 ] for them. On the other hand, the association between psychological distress and QoL was also a hot research direction.…”

Editorial: Exploring the interaction between health-promoting and health risk behaviours in health

“…Shi and In conclusion, studies included in this Research Topic underscore the complex relationship between health-promoting and health-risk behaviors in shaping individuals' health trajectories. By shedding light on the intrinsic mechanisms and contextual elements that shape these behaviors, healthcare practitioners and policymakers can craft tailored interventions aimed at encouraging healthier lifestyles and alleviating the burden of preventable illnesses (6). Additionally, the content of this Research Topic could serve as a valuable material for textbooks on health behavior studies.…”