Perceived economic pressure and health-related quality of life of patients with colorectal cancer after surgery: Evidence from China.

BACKGROUND

Perceived economic burden and health-related quality of life (HRQOL) of patients with colorectal cancer after surgery are limited, which is benefit for understanding the health status of colorectal cancer patients, providing evidence for developing intervention measures, improving prognosis, and enhancing quality of life of patients.

METHODS

A questionnaire-based online investigation was used to collect data from patients with colorectal cancer after surgery between November 2023 and March 2024. The severity of colorectal cancer was categorized to phases 1, 2, 3, and 4 based on the Chinese Society of Clinical Oncology Colorectal Cancer Diagnosis and Treatment Guidelines 2022 Edition. HRQOL was measured using EQ-5D-5L Chinese version. We obtained the health utility value through the integral conversion system, which assigns weights to different levels of the five health dimensions in the EQ-5D-5L scale. Univariate and multivariate logistic regressions were used to analyze the associated factors of utility and VAS score.

RESULTS

227 patients were investigated and incorporated to the data analysis. The mean age of the patients was 63.55 ± 11.71 years old with the average personal annual income of 60000 RMB. As the cancer progresses, different dimensions of HRQOL showed a trend of deterioration. More patients had slight problems in the dimension of pain/discomfort, followed by anxiety/depression, usual activities, self-care and mobility. The EQ-VAS score among colorectal cancer was 87.99, 90.85, 77.04 and 78.28 in phases 1, 2, 3 and 4, respectively ( = 0.000, X = 63.036). The utility score among colorectal cancer was 0.9443, 0.9632, 0.8759 and 0.8494 in phases 1, 2, 3 and 4, respectively ( = 0.000, X = 44.668). Compared to the phase 1, phases 3 and 4 were significantly related to the lower utility and VAS score. Having commercial health insurance was statistically with higher VAS score ( = 0.029). Having a certain amount of pressure was statistically with lower VAS score ( = 0.033).

CONCLUSIONS

We found that postoperative colorectal cancer patients have a relatively high HRQOL but have poorer levels of anxiety/depression and pain/discomfort. Moreover, as the disease progresses and perceived economic pressure increases, the HRQOL of colorectal cancer patients shows a downward trend. Therefore, in daily clinical work, primary health physicians should pay attention to patient health management and economic toxicity, to improve patients' quality of life and reduce their economic pressure.