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Comorbidities are associated with poorer quality of life, functioning and worse symptoms in the 5 years following colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) cohort study

Comorbidities are associated with poorer quality of life, functioning and worse symptoms in the 5 years following colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) cohort study
Comorbidities are associated with poorer quality of life, functioning and worse symptoms in the 5 years following colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) cohort study
Objective

More people are living with the consequences of cancer and comorbidity. We describe frequencies of comorbidities in a colorectal cancer cohort and associations with health and well‐being outcomes up to 5 years following surgery.

Methods

Prospective cohort study of 872 colorectal cancer patients recruited 2010 to 2012 from 29 UK centres, awaiting curative intent surgery. Questionnaires administered at baseline (pre‐surgery), 3, 9, 15, 24 months, and annually up to 5 years. Comorbidities (and whether they limit activities) were self‐reported by participants from 3 months. The EORTC QLQ‐C30 and QLQ‐CR29 assessed global health/quality of life (QoL), symptoms, and functioning. Longitudinal analyses investigated associations between comorbidities and health and well‐being outcomes.

Results

At baseline, the mean age of participants was 68 years, with 60% male and 65% colon cancer. Thirty‐two per cent had 1 and 40% had ≥2 comorbidities. The most common comorbidities were high blood pressure (43%), arthritis/rheumatism (32%), and anxiety/depression (18%). Of those with comorbidities, 37% reported at least 1 that limited their daily activities. Reporting any limiting comorbidities was associated with poorer global health/QoL, worse symptoms, and poorer functioning on all domains over 5‐year follow‐up. Controlling for the most common individual comorbidities, depression/anxiety had the greatest deleterious effect on outcomes.

Conclusions

Clinical assessment should prioritise patient‐reported comorbidities and whether these comorbidities limit daily activities, as important determinants of recovery of QoL, symptoms, and functioning following colorectal cancer. Targeted interventions and support services, including multiprofessional management and tailored assessment and follow‐up, may aid recovery of health and well‐being in these individuals.
1057-9249
2427-2435
Cummings, Amanda
7c5f6bd2-979b-456d-9368-8edd13c06691
Grimmett, Chloe
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Calman, Lynn
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Patel, Mubarak
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Permyakova, Natalia
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Winter, Jane
768d4b60-3b95-458c-bef6-81264fa10c1c
Corner, Jessica
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Din, Amy
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Fenlon, Deborah
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Richardson, Alison
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Smith, Peter W.F.
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Foster, Claire
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Cummings, Amanda
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Grimmett, Chloe
7f27e85b-2850-481d-a7dd-2835e1a925cd
Calman, Lynn
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Patel, Mubarak
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Permyakova, Natalia
27793eb1-9b3d-4194-8e80-8d0d4c0798ea
Winter, Jane
768d4b60-3b95-458c-bef6-81264fa10c1c
Corner, Jessica
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Din, Amy
4ca3c758-ec41-4c76-baf6-95ad788f5336
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Richardson, Alison
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Smith, Peter W.F.
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Foster, Claire
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Cummings, Amanda, Grimmett, Chloe, Calman, Lynn, Patel, Mubarak, Permyakova, Natalia, Winter, Jane, Corner, Jessica, Din, Amy, Fenlon, Deborah, Richardson, Alison, Smith, Peter W.F. and Foster, Claire (2018) Comorbidities are associated with poorer quality of life, functioning and worse symptoms in the 5 years following colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) cohort study. Psycho-Oncology, 2427-2435. (doi:10.1002/pon.4845).

Record type: Article

Abstract

Objective

More people are living with the consequences of cancer and comorbidity. We describe frequencies of comorbidities in a colorectal cancer cohort and associations with health and well‐being outcomes up to 5 years following surgery.

Methods

Prospective cohort study of 872 colorectal cancer patients recruited 2010 to 2012 from 29 UK centres, awaiting curative intent surgery. Questionnaires administered at baseline (pre‐surgery), 3, 9, 15, 24 months, and annually up to 5 years. Comorbidities (and whether they limit activities) were self‐reported by participants from 3 months. The EORTC QLQ‐C30 and QLQ‐CR29 assessed global health/quality of life (QoL), symptoms, and functioning. Longitudinal analyses investigated associations between comorbidities and health and well‐being outcomes.

Results

At baseline, the mean age of participants was 68 years, with 60% male and 65% colon cancer. Thirty‐two per cent had 1 and 40% had ≥2 comorbidities. The most common comorbidities were high blood pressure (43%), arthritis/rheumatism (32%), and anxiety/depression (18%). Of those with comorbidities, 37% reported at least 1 that limited their daily activities. Reporting any limiting comorbidities was associated with poorer global health/QoL, worse symptoms, and poorer functioning on all domains over 5‐year follow‐up. Controlling for the most common individual comorbidities, depression/anxiety had the greatest deleterious effect on outcomes.

Conclusions

Clinical assessment should prioritise patient‐reported comorbidities and whether these comorbidities limit daily activities, as important determinants of recovery of QoL, symptoms, and functioning following colorectal cancer. Targeted interventions and support services, including multiprofessional management and tailored assessment and follow‐up, may aid recovery of health and well‐being in these individuals.

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Comorbidities are associated with poorer quality of life, functioning and worse symptoms in the 5 years following colorectal cancer surgery: Results from the ColoREctal Wellbeing (CREW) cohort study - Accepted Manuscript
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Comorbidities are associated with poorer quality of life, functioning and worse symptoms in the 5 years following colorectal cancer surgery: Results from the ColoREctal Wellbeing (CREW) cohort study - Accepted Manuscript
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More information

Accepted/In Press date: 19 July 2018
e-pub ahead of print date: 1 August 2018

Identifiers

Local EPrints ID: 423713
URI: http://eprints.soton.ac.uk/id/eprint/423713
ISSN: 1057-9249
PURE UUID: 6fe7bb3a-38fa-4765-869b-58882fc5c793
ORCID for Chloe Grimmett: ORCID iD orcid.org/0000-0002-7540-7206
ORCID for Lynn Calman: ORCID iD orcid.org/0000-0002-9964-6017
ORCID for Mubarak Patel: ORCID iD orcid.org/0000-0001-7573-1447
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Peter W.F. Smith: ORCID iD orcid.org/0000-0003-4423-5410
ORCID for Claire Foster: ORCID iD orcid.org/0000-0002-4703-8378

Catalogue record

Date deposited: 27 Sep 2018 16:30
Last modified: 17 Dec 2019 05:16

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Contributors

Author: Amanda Cummings
Author: Chloe Grimmett ORCID iD
Author: Lynn Calman ORCID iD
Author: Mubarak Patel ORCID iD
Author: Natalia Permyakova
Author: Jane Winter
Author: Jessica Corner
Author: Amy Din
Author: Deborah Fenlon
Author: Claire Foster ORCID iD

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