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Quality of life and health status in older adults (≥65 years) up to five years following colorectal cancer treatment: Findings from the ColoREctal Wellbeing (CREW) cohort study

Quality of life and health status in older adults (≥65 years) up to five years following colorectal cancer treatment: Findings from the ColoREctal Wellbeing (CREW) cohort study
Quality of life and health status in older adults (≥65 years) up to five years following colorectal cancer treatment: Findings from the ColoREctal Wellbeing (CREW) cohort study

Objective Colorectal cancer (CRC) is common in older adults, with more than 70% of diagnoses in people aged ≥65 years. Despite this, there is a knowledge gap regarding longer-term outcomes in this population. Here, we identify those older people most at risk of poor quality of life (QoL) and health status in the five years following CRC treatment. Materials and methods CREW is a UK longitudinal cohort study investigating factors associated with health and wellbeing recovery following curative-intent CRC surgery. Participants completed self-report questionnaires pre-surgery, then at least annually up to five years. Longitudinal analyses explored the prevalence and pre-surgery risk factors of poor QoL (QLACS-GSS) and health status (EQ-5D: presence/absence of problems in five domains) in older (≥65 years) participants over five years. Results 501 participants aged ≥65years completed questionnaires pre-surgery; 45% completed questionnaires five years later. Oldest-old participants (≥80 years) reported poorer QoL (18% higher QLACS-GSS) and 2–4 times higher odds of having problems with mobility or usual activities, compared with the youngest-old (65–69 years) over follow-up. Baseline higher self-efficacy was significantly associated with better QoL (10–30% lower QLACS-GSS scores compared to those with low self-efficacy) and lower odds of problems in all EQ-5D domains. Adequate social support was significantly associated with better QoL (8% lower QLACS-GSS) and lower odds of problems with usual activities (OR = 0.62) and anxiety/depression (OR = 0.56). Conclusion There are important differences in QoL and health status outcomes for the oldest-old during CRC recovery. CREW reveals pre-surgery risk factors that are amenable to intervention including self-efficacy and social support.

1932-6203
Cummings, Amanda
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Foster, Rebecca
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Calman, Lynn
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Permyakova, Natalia V.
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Bridges, Jackie
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Wiseman, Theresa
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Corbett, Teresa
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Smith, Peter W. F.
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Foster, Claire
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Kardeş, Sinan
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Cummings, Amanda
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Foster, Rebecca
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Calman, Lynn
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Permyakova, Natalia V.
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Bridges, Jackie
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Wiseman, Theresa
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Corbett, Teresa
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Smith, Peter W. F.
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Foster, Claire
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Kardeş, Sinan
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Cummings, Amanda, Foster, Rebecca, Calman, Lynn, Permyakova, Natalia V., Bridges, Jackie, Wiseman, Theresa, Corbett, Teresa, Smith, Peter W. F. and Foster, Claire , Kardeş, Sinan (ed.) (2022) Quality of life and health status in older adults (≥65 years) up to five years following colorectal cancer treatment: Findings from the ColoREctal Wellbeing (CREW) cohort study. PLoS ONE, 17 (7), [e0270033]. (doi:10.1371/journal.pone.0270033).

Record type: Article

Abstract

Objective Colorectal cancer (CRC) is common in older adults, with more than 70% of diagnoses in people aged ≥65 years. Despite this, there is a knowledge gap regarding longer-term outcomes in this population. Here, we identify those older people most at risk of poor quality of life (QoL) and health status in the five years following CRC treatment. Materials and methods CREW is a UK longitudinal cohort study investigating factors associated with health and wellbeing recovery following curative-intent CRC surgery. Participants completed self-report questionnaires pre-surgery, then at least annually up to five years. Longitudinal analyses explored the prevalence and pre-surgery risk factors of poor QoL (QLACS-GSS) and health status (EQ-5D: presence/absence of problems in five domains) in older (≥65 years) participants over five years. Results 501 participants aged ≥65years completed questionnaires pre-surgery; 45% completed questionnaires five years later. Oldest-old participants (≥80 years) reported poorer QoL (18% higher QLACS-GSS) and 2–4 times higher odds of having problems with mobility or usual activities, compared with the youngest-old (65–69 years) over follow-up. Baseline higher self-efficacy was significantly associated with better QoL (10–30% lower QLACS-GSS scores compared to those with low self-efficacy) and lower odds of problems in all EQ-5D domains. Adequate social support was significantly associated with better QoL (8% lower QLACS-GSS) and lower odds of problems with usual activities (OR = 0.62) and anxiety/depression (OR = 0.56). Conclusion There are important differences in QoL and health status outcomes for the oldest-old during CRC recovery. CREW reveals pre-surgery risk factors that are amenable to intervention including self-efficacy and social support.

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Accepted/In Press date: 6 July 2022
Published date: 14 July 2022
Additional Information: Funding Information: The ColoREctal Well-being (CREW) study is funded by Macmillan Cancer Support grant number 3546834. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank all CREW study participants and recruiting NHS Trusts; Carol Hill, Kerry Coleman, Bjoern Schukowsky, Christine May (study support); Matthew Breckons, Cassandra Powers, Alex Recio-Saucedo, Bina Nausheen, Ikumi Okamoto, Kim-Chivers Seymour, Joanne Haviland (researchers); Jo Clough, Alison Farmer (research partners). Members of the Study Advisory Committee: Jo Armes, Janis Baird, Andrew Bateman, Nick Beck, Graham Moon, Claire Hulme, Peter Hall, Karen Poole, Susan Restorick-Banks, Paul Roderick, Claire Taylor, Jocelyn Walters, Fran Williams, Lynn Batehup, Jessica Corner, and Deborah Fenlon. Publisher Copyright: © 2022 Cummings et al.

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Local EPrints ID: 468899
URI: http://eprints.soton.ac.uk/id/eprint/468899
ISSN: 1932-6203
PURE UUID: e498e9e8-f097-48ad-8d66-5c39f8688f39
ORCID for Amanda Cummings: ORCID iD orcid.org/0000-0002-5743-2774
ORCID for Rebecca Foster: ORCID iD orcid.org/0000-0002-9320-4269
ORCID for Lynn Calman: ORCID iD orcid.org/0000-0002-9964-6017
ORCID for Jackie Bridges: ORCID iD orcid.org/0000-0001-6776-736X
ORCID for Theresa Wiseman: ORCID iD orcid.org/0000-0002-3355-1269
ORCID for Teresa Corbett: ORCID iD orcid.org/0000-0002-5620-5377
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

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Date deposited: 31 Aug 2022 16:56
Last modified: 16 Sep 2022 01:47

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Contributors

Author: Amanda Cummings ORCID iD
Author: Rebecca Foster ORCID iD
Author: Lynn Calman ORCID iD
Author: Natalia V. Permyakova
Author: Jackie Bridges ORCID iD
Author: Theresa Wiseman ORCID iD
Author: Teresa Corbett ORCID iD
Author: Claire Foster ORCID iD
Editor: Sinan Kardeş

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