Time from Diagnosis and Correlates of Health-Related Quality of Life among Young Adult Colorectal Cancer Survivors

Abstract

The incidence of colorectal cancer (CRC) is rising among young adults. Health-related quality of life (HRQoL) in survivorship is not well-described in this population. We assessed HRQoL among young adult CRC survivors diagnosed from age 18–39 (AYAs) to examine differences by time from diagnosis, and to identify key correlates. A cross-sectional online survey was administered in collaboration with a national patient advocacy organization. The Functional Assessment of Cancer Therapy (FACT-C) was used to measure HRQoL, which assesses HRQoL globally and across 4 domains: emotional, physical, social, and functional. T-tests were conducted to compare HRQoL between survivors who were 6–18 months versus 19–36 months from diagnosis or relapse and multiple linear regression was conducted to identify correlates. The sample (n = 196) had a mean age of 32.2(SD ± 4.5); 116 (59.9%) were male; and the self-reported tumor location was colon (39.3%) or rectal (60.7%). The majority (56.4%) were diagnosed with stage 2 disease; 96.9% were non-metastatic. The mean global HRQoL score was 67.7 out of a possible score of 136. Across domains, mean scores were low. Emotional and physical well-being were significantly higher among survivors who were 19–36 months from diagnosis/relapse compared to those 6–18 months from diagnosis/relapse. Longer time from diagnosis and older current age were associated with higher HRQoL, while more intensive treatment and higher clinical disease stage were negatively associated, particularly in the emotional and physical domains. Overall, HRQoL was low in this population, and further research is needed to inform age-appropriate interventions to improve HRQoL for AYA CRC survivors.

Comprehensive Score for Financial Toxicity and Health-Related Quality of Life in Patients With Cancer and Survivors: A Systematic Review and Meta-Analysis

“…There are some distinctive findings from the included studies. First, 1 study in the United States failed to detect a significant association between financial toxicity and HRQOL in colorectal patients, using FACT-C. 68 Despite the results being insignificant, the association between COST and FACT-C was as expected indicating a decline in HRQOL with higher financial toxicity outcomes. Interestingly, this was the only study to focus on young adults with a mean age of 32 years (range = 20-42).…”

“…For correlation analysis, 17 studies used Pearson's correlation, 3 studies used Spearman's correlation, and 3 did not specify the type. All but one studies using univariate analyses 68 reported a significant association between financial toxicity and HRQOL. Across the 4 studies that used bivariate linear regressions to predict HRQOL from COST scores, none used the same HRQOL instruments: BREAST-Q and 12-Item Short Form Health Survey, 56 FACT -Brain cancer, 63 EORTC QLQ-C30, 66 and FACT -Colorectal cancer (FACT-C).…”

“…Across the 4 studies that used bivariate linear regressions to predict HRQOL from COST scores, none used the same HRQOL instruments: BREAST-Q and 12-Item Short Form Health Survey, 56 FACT -Brain cancer, 63 EORTC QLQ-C30, 66 and FACT -Colorectal cancer (FACT-C). 68 One study estimated a different model by regressing COST scores on FACT-G -7-Item Version. 81…”

Fertility Preservation Discussions Between Young Adult Rectal Cancer Survivors and Their Providers: Sex-Specific Prevalence and Correlates

“…An online, cross-sectional survey was administered on the Facebook page of a national colorectal cancer (CRC) advocacy organization, the Colon Club, between August 31 and September 3, 2020. 23 , 24 The Colon Club Facebook page has approximately 7000 members and strives to raise awareness, educate, and help those with CRC, particularly those diagnosed as YAs and are based in the US. Eligible participants were either colon or rectal cancer survivors under age 50 at diagnosis, between 6 and 36 months from diagnosis or relapse, and based in the US.…”

Early‐onset colorectal cancer: why it should be high on our list of differentials

“…To our knowledge, only one study exists which quantitatively investigates the HRQoL of EOCRC patients. Utilizing the Functional Assessment of Cancer Therapy‐Colorectal (FACT‐C) questionnaire, Miller et al 46 . compared the HRQoL of EOCRC patients 6–18 months and 19–36 months from diagnosis.…”