Quality of life among long-term (≥5 years) colorectal cancer survivors--systematic review

Background: Due to the growing number of long-term (≥5 years) colorectal cancer survivors, investigation of their quality of life (QoL) is important for an evaluation of chronic or late effects of the disease and treatment and to adjust treatment strategies to patients' needs.

Method: To summarise current research results, multiple databases including PubMed, EMBASE and CINAHL were used to identify articles about long-term QoL of colorectal cancer survivors. The content of 10 included studies was independently extracted by two reviewers.

Results: Colorectal cancer survivors indicated a good overall QoL, but may have slightly lower physical QoL than the general population. Furthermore, survivors had worse depression scores and reported to suffer from long-term symptoms such as bowel problems and distress regarding cancer. Apart from stoma and recurrence of the disease, mainly general and health-related factors such as age, social network size, income, education, BMI and number of comorbidities were associated with QoL. Studies were mainly conducted in the United States (US) (n=7) and were heterogeneous with respect to the QoL instrument used and the adjustment to covariates. QoL assessment was cross-sectional in all studies.

Conclusion: Despite an overall good QoL, colorectal cancer survivors have specific physical and psychological problems. The reported determinants of QoL may serve to identify survivors with special needs. But further studies are needed that focus on problems like distress, depression and bowel problems of long-term colorectal cancer survivors.