Paul Christine L, Cameron Emilie, Doran Christopher, Hill David, Macrae Finlay, Carey Mariko L, Sanson-Fisher Rob W
Priority Research Centre for Health Behaviour (PRCHB), School of Medicine & Public Health, University of Newcastle, W4, HMRI Building, Callaghan, NSW, 2308, Australia.
Hunter Medical Research Institute (HMRI), New Lambton, NSW, Australia.
Support Care Cancer. 2016 Dec;24(12):4921-4928. doi: 10.1007/s00520-016-3348-2. Epub 2016 Jul 16.
There are few recent longitudinal studies investigating the quality of life of colorectal cancer patients in the early years following diagnosis. This study aimed to (i) compare the health status of people with colorectal cancer less than 1 year from diagnosis with health status 1 year later and (ii) determine the characteristics associated with a change in overall health status.
The study was conducted as part of a larger trial. Participants (n = 539) were identified via the Victorian Cancer Registry in Australia, completed a computer-assisted baseline telephone interview (including the EQ-5D-3L) within 6-12 months of diagnosis, and mailed a survey 12 months later.
At baseline, the majority of participants (55 %) reported some problems, including difficulties in usual activities (26 %), pain or discomfort (25 %), anxiety or depression (23 %) and mobility issues (15 %). Sixty-nine percent had either an unchanged or increased health utility score from baseline to follow-up. The largest proportion reporting an increase in problems between baseline and follow-up related to pain or discomfort (18 %). While visual analogue scale scores indicated a significantly improved health state over time overall, 32 % reported a decreased health utility score from baseline to follow-up. Those aged over 80 years were more likely to report a decreased health utility score compared to 60-80-year-olds.
A sizeable minority of patients experience ongoing problems in their daily lives and should be offered assistance in overcoming disabilities and returning to best possible functioning, particularly older patients who appear to be vulnerable to poor outcomes.
近期鲜有纵向研究调查结直肠癌患者确诊后最初几年的生活质量。本研究旨在：（i）比较确诊后不到1年的结直肠癌患者与1年后的健康状况；（ii）确定与总体健康状况变化相关的特征。
本研究是一项更大规模试验的一部分。通过澳大利亚维多利亚癌症登记处确定参与者（n = 539），他们在确诊后6 - 12个月内完成了一次计算机辅助的基线电话访谈（包括EQ - 5D - 3L），并在12个月后邮寄了一份调查问卷。
在基线时，大多数参与者（55%）报告了一些问题，包括日常活动困难（26%）、疼痛或不适（25%）、焦虑或抑郁（23%）以及行动不便（15%）。从基线到随访，69%的人的健康效用得分未变或有所增加。报告在基线和随访之间问题增加最多的是疼痛或不适（18%）。虽然视觉模拟量表评分总体上表明随着时间推移健康状况有显著改善，但32%的人报告从基线到随访健康效用得分下降。与60 - 80岁的人相比，80岁以上的人更有可能报告健康效用得分下降。
相当一部分患者在日常生活中持续存在问题，应该为他们提供帮助以克服残疾并恢复到最佳功能状态，特别是那些似乎易出现不良预后的老年患者。
