Trajectories of quality of life, health status and personal wellbeing in the 
two years following curative intent treatment for colorectal cancer: results 
from the UK ColoREctal Wellbeing (CREW) cohort study | NCRI Cancer Conference 
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B194: Trajectories of quality of life, health status and personal wellbeing in 
the two years following curative intent treatment for colorectal cancer: results 
from the UK ColoREctal Wellbeing (CREW) cohort study


Claire Foster1,3,Joanne Haviland1,3,Jane Winter2,3,Chloe Grimmett1,3,Kim Chivers 
Seymour3,Lynn Batehup3,Lynn Calman1,3,Jessica Corner3,Amy Din1,3,Deborah 
Fenlon3,Christine M May1,3,Peter W Smith4,Alison Richardson2,3


1Macmillan Survivorship Research Group, Faculty of Health Sciences, University 
of Southampton, Southampton, UK,2University Hospital Southampton NHS Foundation 
Trust, Southampton, UK,3Faculty of Health Sciences, University of Southampton, 
Southampton, UK,4Southampton Statistical Sciences Research Institute, University 
of Southampton, Southampton, UK

Presenting date: Monday 2 November

Presenting time: 16.50 - 17.05


Background


 

Cancer survivorship is a growing global concern and the current aftercare system 
does not sufficiently meet patients’ needs.  It is important to understand 
patterns of recovery in order to tailor aftercare appropriately. We examine 
trajectories of quality of life (QoL), health status and personal wellbeing in 
the first two years following colorectal surgery



Method


Prospective cohort study of 872 UK colorectal cancer patients who consented to 
follow-up. Questionnaires at baseline (pre-surgery), 3, 9, 15, 24 months. QoL 
(Quality of Life in Adult Cancer Survivors, QLACS), health status (EQ-5D), 
personal wellbeing (Personal Wellbeing Index), physical symptoms, anxiety, 
depression, self-efficacy, social support, socio-demographic and 
clinical/treatment characteristics were examined. Longitudinal analyses assessed 
change in QoL, health and wellbeing over time and predictors of trajectories



Results


Four distinct trajectories (groups) were identified for each outcome measure. 
Group 1: consistently good QoL (31.3%), mild and improving health problems 
(20.9%), consistently good wellbeing (44.9%). Groups 2 and 3 displayed 
intermediate and changing levels of QoL, health status and personal wellbeing. 
Group 4: consistently poor QoL (5.3%) and health status (7.4%), very 
poor/declining wellbeing (4.2%). 11.5% were in Group 4 for at least one of the 
outcome measures. Factors statistically significantly associated with poorer 
trajectories: higher deprivation, more comorbidities, stoma, worse physical and 
psychological symptoms, lower self-efficacy to self-manage and less social 
support



Conclusion


Results from this large representative study show that distinct recovery 
trajectories following surgery for colorectal cancer can be identified with risk 
factors. Different approaches to follow-up care are warranted and these results 
provide robust data regarding who is likely to need more intensive support, 
which will inform the development of risk-stratified follow-up management 
tailored to an individual’s need.  This provides NHS commissioners with 
cost-effective, comprehensive packages of care for this patient group




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