Department of Biostatistics, Faculty of Medicine, University of Franche-Comté, Besançon, France.
Oncologist. 2011;16(11):1626-36. doi: 10.1634/theoncologist.2011-0036. Epub 2011 Oct 10.
The number of long-term colorectal cancer survivors is increasing. Cancer and its treatment can cause physical and psychological complications, but little is known about how it impacts quality of life (QOL) over the long term-5, 10, and 15 years after diagnosis.
Cancer survivors were randomly selected from three tumor registries in France, diagnosed in 1990 (±1 year), 1995 (±1 year), and 2000 (±1 year). Controls were randomly selected from electoral rolls, stratifying on gender, age group, and residence area. Participants completed two QOL questionnaires, a fatigue questionnaire, an anxiety questionnaire, and a life conditions questionnaire. An analysis of variance was used to compare QOL scores of cancer survivors by period of diagnosis (5, 10, and 15 years) with those of controls, adjusted for sociodemographic data and comorbidities.
We included 344 colon cancer and 198 rectal cancer survivors and 1,181 controls. In a global analysis, survivors reported a statistically and clinically significant lower score in social functioning 5 years after diagnosis and higher scores in diarrhea symptoms 5 and 10 years after diagnosis. In subgroup analyses, rectal cancer affected QOL in the physical dimensions at 5 years and in the fatigue dimensions at 5 and 10 years.
Survivors of colorectal cancer may experience the effects of cancer and its treatment up to 10 years after diagnosis, particularly for rectal cancer. Clinicians, psychologists, and social workers must pay special attention to rectal cancer survivors to improve overall management.
长期结直肠癌幸存者的数量正在增加。癌症及其治疗会导致身体和心理并发症,但对于其在诊断后 5、10 和 15 年对生活质量(QOL)的长期影响知之甚少。
从法国三个肿瘤登记处随机选择癌症幸存者,诊断时间为 1990 年(±1 年)、1995 年(±1 年)和 2000 年(±1 年)。对照组从选民名单中随机选择,按性别、年龄组和居住区域分层。参与者完成了两份 QOL 问卷、一份疲劳问卷、一份焦虑问卷和一份生活条件问卷。使用方差分析比较了按诊断期(5、10 和 15 年)划分的癌症幸存者与对照组的 QOL 评分,调整了社会人口统计学数据和合并症。
我们纳入了 344 例结肠癌和 198 例直肠癌幸存者和 1181 名对照者。在总体分析中,幸存者在诊断后 5 年报告了社会功能方面存在统计学上和临床上显著较低的得分,在诊断后 5 年和 10 年报告了腹泻症状方面更高的得分。在亚组分析中,直肠癌在 5 年时影响了身体维度的 QOL,在 5 年和 10 年时影响了疲劳维度的 QOL。
结直肠癌幸存者可能在诊断后 10 年内经历癌症及其治疗的影响,特别是直肠癌。临床医生、心理学家和社会工作者必须特别关注直肠癌幸存者,以改善整体管理。