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

Gray, N. M.; Lee, Amanda; Hall, S. J.; Browne, Susan; Browne, S.; Gray, Nicola; Macleod, U.; Hall, Susan; Mitchell, E.; Johnston, Marie; Lee, A. J.; Johnston, M.; Samuel, Leslie; Wyke, S.; Samuel, L.; Weller, David; Wyke, Sally; Weller, D.; Campbell, N. C.


N. M. Gray

S. J. Hall

Susan Browne

S. Browne

Nicola Gray

Susan Hall

E. Mitchell

Marie Johnston

M. Johnston

Leslie Samuel

S. Wyke

L. Samuel

David Weller

Sally Wyke

D. Weller

N. C. Campbell


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.


Gray, N. M., Hall, S. J., Browne, S., Macleod, U., Mitchell, E., Lee, A. J., …Campbell, N. C. (2011). Modifiable and fixed factors predicting quality of life in people with colorectal cancer. The British journal of cancer / Cancer Research Campaign, 104(11), 1697-1703.

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 Cancer Research UK
Peer Reviewed Peer Reviewed
Volume 104
Issue 11
Pages 1697-1703
Keywords Quality of life; Colorectal cancer; Assessment
Public URL
Publisher URL
Copyright Statement From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License.
Additional Information Copy of article first published in: British journal of cancer, 2011, v.104, issue 11.


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