Institute of Epidemiology, Christian-Albrechts University of Kiel, Campus Kiel, UKSH, Arnold-Heller-Str. 3, Haus 1, 24105, Kiel, Germany,
Cancer Causes Control. 2014 Jan;25(1):99-110. doi: 10.1007/s10552-013-0313-y. Epub 2013 Oct 25.
This study investigates the association between a postdiagnosis lifestyle score and health-related quality of life (HrQol) in long-term colorectal cancer (CRC) survivors.
A cross-sectional study of 1,389 long-term CRC survivors in Northern Germany was analyzed. On average 7.2 years after CRC diagnosis, HrQol was assessed with the EORTC QLQ-C30, and lifestyle factors, including weight, height, diet, physical activity, and smoking were obtained using self-administered questionnaires. A lifestyle score (BMI <30 kg/m², healthy diet, recreationally active, and not smoking) was applied. Participants were categorized in adhering to at most one, two, three, or all recommended lifestyle factors, categorizing unfavorable behaviors with 0 and favorable with 1 point. Multivariable logistic regression models were used to investigate the association between the lifestyle score and HrQol as a binary variable.
Approximately 10 % had at most one, 30 % two, 38 % three, and 23 % all favorable factors. Compared to participants with one or zero factors, the odds ratio (OR) for a low global HrQol (gHrQol) decreased with stronger adherence to the score. The OR (95% CI) for a low gHrQol was 0.50 (0.33-0.76) for participants with all favorable lifestyle factors compared to participants with one or zero. Clinical and socio-demographic factors had little impact on these associations, with exception of living arrangement which showed a statistically significant interaction. Associations were stronger for functioning domains, representing mobility rather than mental health.
Favorable lifestyle behaviors might be associated with HrQol in CRC long-term survivors. More research in prospective studies is needed.
本研究旨在调查诊断后生活方式评分与长期结直肠癌（CRC）幸存者健康相关生活质量（HRQoL）之间的关系。
对德国北部 1389 名长期 CRC 幸存者进行了横断面研究。在 CRC 诊断后平均 7.2 年，使用 EORTC QLQ-C30 评估 HRQoL，使用自我管理问卷获得生活方式因素，包括体重、身高、饮食、身体活动和吸烟。应用生活方式评分（BMI<30kg/m²、健康饮食、有规律的体力活动和不吸烟）。将参与者分为最多遵循一项、两项、三项或所有推荐生活方式因素的人群，将不良行为归类为 0 分，有利行为归类为 1 分。采用多变量逻辑回归模型，将生活方式评分与 HRQoL 作为二分类变量进行关联分析。
约 10%的参与者最多遵循一项、30%的参与者遵循两项、38%的参与者遵循三项、23%的参与者遵循所有有利因素。与仅遵循一项或零项因素的参与者相比，对 HRQoL 评分较低的优势比（OR）随着评分的一致性增加而降低。与仅遵循一项或零项因素的参与者相比，所有有利生活方式因素的参与者发生低 gHRQoL 的 OR（95%CI）为 0.50（0.33-0.76）。除生活安排外，临床和社会人口统计学因素对这些关联的影响很小，生活安排存在统计学显著的交互作用。这些关联在功能领域更为明显，代表的是移动能力而非心理健康。
有利的生活方式行为可能与 CRC 长期幸存者的 HRQoL 相关。需要更多的前瞻性研究。
