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

Cummings, Amanda and Grimmett, Chloe and Calman, Lynn and Patel, Mubarak and Permyakova, Natalia Vadimovna and Winter, Jane and Corner, Jessica and Din, Amy and Fenlon, Deborah and Richardson, Alison and Smith, Peter W. and Foster, Claire (2018) Comorbidities are associated with poorer quality of life and functioning and worse symptoms in the 5 years following colorectal cancer surgery: Results from the ColoREctal Well-being (CREW) cohort study. Psycho-Oncology . ISSN 1099-1611

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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.

Item Type: Article
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.
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: https://doi.org/10.1002/pon.4845
Depositing User: Eprints, Support
Date Deposited: 20 Sep 2018 08:57
Last Modified: 01 Aug 2019 04:30
URI: http://eprints.nottingham.ac.uk/id/eprint/55063

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