Department of Psychology and Social Behavior, University of California, Irvine, Irvine, California.
Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
Dis Colon Rectum. 2018 Mar;61(3):355-363. doi: 10.1097/DCR.0000000000000972.
Data are lacking regarding physical functioning, psychological well-being, and quality of life among colorectal cancer survivors >10 years postdiagnosis.
The purpose of this study was to examine self-reported physical functioning, quality of life, and psychological well-being in long-term colorectal cancer survivors compared with age- and sex-matched unaffected control subjects.
Participants completed a cross-sectional survey.
The colorectal cancer survivors and unaffected control subjects were recruited from the Ontario Familial Colorectal Cancer Registry.
A population-based sample of colorectal cancer survivors (N = 296) and their age- and sex-matched unaffected control subjects (N = 255) were included. Survivors were, on average, 15 years postdiagnosis.
Quality of life was measured with the Functional Assessment of Cancer Therapy-General scale, bowel dysfunction with the Memorial Sloan-Kettering Cancer Center scale, urinary dysfunction with the International Consultation on Incontinence Questionnaire-Short Form, fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue scale, and depression with the Center for Epidemiologic Studies-Depression scale.
In linear mixed-model analyses adjusting for income, education, race, and comorbid medical conditions, survivors reported good emotional, functional, physical, and overall quality of life, comparable to control subjects. Fatigue and urinary functioning did not differ significantly between survivors and control subjects. Survivors reported significantly higher social quality of life and lower depression compared with unaffected control subjects. The only area where survivors reported significantly worse deficits was in bowel dysfunction, but the magnitude of differences was relatively small.
Generalizability is limited by moderately low participation rates. Findings are likely biased toward healthy participants. No baseline assessment was available to examine change in outcomes over time.
Long-term colorectal cancer survivors appear to have comparable quality of life and, in some areas, better well-being than their unaffected peers. Bowel dysfunction may continue to be an ongoing issue even 15 years after colorectal cancer diagnosis. Overall quality of life can be expected to be good in this group of older survivors. See Video Abstract at http://links.lww.com/DCR/A476.
缺乏关于诊断后 10 年以上的结直肠癌幸存者的身体功能、心理幸福感和生活质量的数据。
本研究旨在比较长期结直肠癌幸存者和年龄、性别匹配的未受影响对照者的自我报告身体功能、生活质量和心理幸福感。
参与者完成了一项横断面调查。
结直肠癌幸存者和未受影响对照者是从安大略家族性结直肠癌登记处招募的。
纳入了基于人群的结直肠癌幸存者样本（N=296）及其年龄和性别匹配的未受影响对照者（N=255）。幸存者的平均诊断后时间为 15 年。
生活质量采用癌症治疗功能评估-一般量表测量，肠道功能障碍采用纪念斯隆-凯特琳癌症中心量表测量，尿功能障碍采用国际尿失禁咨询问卷-简短形式测量，疲劳采用慢性病治疗功能评估-疲劳量表测量，抑郁采用流行病学研究中心抑郁量表测量。
在调整收入、教育、种族和合并医疗状况的线性混合模型分析中，与对照者相比，幸存者报告了良好的情感、功能、身体和总体生活质量。疲劳和尿功能无显著差异。幸存者报告的社会生活质量显著较高，抑郁程度显著较低。唯一报告身体功能障碍显著较差的领域是肠道功能障碍，但差异幅度相对较小。
参与率适中较低，限制了推广性。研究结果可能偏向于健康的参与者。没有基线评估来检查随时间的结果变化。
长期结直肠癌幸存者的生活质量似乎与未受影响的同龄人相当，在某些方面，他们的幸福感更好。即使在结直肠癌诊断后 15 年，肠道功能障碍可能仍然是一个持续存在的问题。在这组年龄较大的幸存者中，整体生活质量预计会很好。
