Modifiable and fixed factors predicting quality of life in people with colorectal cancer

Gray, N. M.; Hall, S. J.; Browne, S.; Macleod, U.; Mitchell, E.; Lee, A. J.; Johnston, M.; Wyke, S.; Samuel, L.; Weller, D.; Campbell, N. C.

Abstract

BACKGROUND: People with colorectal cancer have impaired quality of life (QoL). We investigated what factors were most highly associated with it. METHODS: Four hundred and ninety-six people with colorectal cancer completed questionnaires about QoL, functioning, symptoms, co-morbidity, cognitions and personal and social factors. Disease, treatment and co-morbidity data were abstracted from case notes. Multiple linear regression identified modifiable and unmodifiable factors independently predictive of global quality of life (EORTC-QLQ-C30). RESULTS: Of unmodifiable factors, female sex (P<0.001), more self-reported co-morbidities (P = 0.006) and metastases at diagnosis (P = 0.036) significantly predicted poorer QoL, but explained little of the variability in the model (R² = 0.064). Adding modifiable factors, poorer role (P<0.001) and social functioning (P = 0.003), fatigue (P = 0.001), dyspnoea (P 0.001), anorexia (P<0.001), depression (P<0.001) and worse perceived consequences (P = 0.013) improved the model fit considerably (R² = 0.574). Omitting functioning subscales resulted in recent diagnosis (P = 0.002), lower perceived personal control (P = 0.020) and travel difficulties (P<0.001) becoming significant predictors. CONCLUSION: Most factors affecting QoL are modifiable, especially symptoms (fatigue, anorexia, dyspnoea) and depression. Beliefs about illness are also important. Unmodifiable factors, including metastatic (or unstaged) disease at diagnosis, have less impact. There appears to be potential for interventions to improve QoL in patients with colorectal cancer.

Citation

Gray, N. M., Hall, S. J., Browne, S., Macleod, U., Mitchell, E., Lee, A. J., Johnston, M., Wyke, S., Samuel, L., Weller, D., & Campbell, N. C. (2011). Modifiable and fixed factors predicting quality of life in people with colorectal cancer. The British Journal of Cancer, 104(11), 1697-1703. https://doi.org/10.1038/bjc.2011.155

• Journal Article Type: Article
• Acceptance Date: Apr 7, 2011
• Online Publication Date: May 10, 2011
• Publication Date: May 24, 2011
• Deposit Date: Nov 13, 2014
• Publicly Available Date: Nov 13, 2014
• Journal: British journal of cancer
• Print ISSN: 0007-0920
• Electronic ISSN: 1532-1827
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 104
• Issue: 11
• Pages: 1697-1703
• DOI: https://doi.org/10.1038/bjc.2011.155
• Keywords: Quality of life; Colorectal cancer; Assessment
• Public URL: https://hull-repository.worktribe.com/output/462685
• Publisher URL: http://www.nature.com/bjc/journal/v104/n11/full/bjc2011155a.html
• Additional Information: Copy of article first published in: British journal of cancer, 2011, v.104, issue 11.
• Contract Date: Nov 13, 2014