Measurement of Health-Related Quality of Life in the Early Follow-Up of Colon and Rectal Cancer

PURPOSE: Little is known about factors that affect health-related quality of life during the early follow-up of colorectal cancer. This study was designed to identify the factors that contribute to poor health-related quality of life after six weeks of follow-up and to compare the relative performance of instruments best suited to measure it. METHODS: A single-center, prospective study was designed to examine health-related quality of life after potentially curative surgery for colorectal cancer. Two condition-specific and two generic instruments (QLQ-C30, FACT-C, SF12 and EQ-5D) measured quality of life six weeks after discharge. Univariate and multivariate analyses were used to assess the impact of 16 treatment factors, demographic variables, and symptoms on seven global health-related quality of life scores. RESULTS: Questionnaires were obtained from 201 consecutive patients. Five factors were associated with poor health-related quality of life scores at six-week follow-up in the multivariate analysis: reduced preoperative performance status, stomas, diarrhea, constipation, and younger than aged 65 years. No instrument out performed the others. However, condition-specific instruments and those in which patients subjectively rated their overall health-related quality of life were better suited to detect health-related quality of life differences relating to the effects of colorectal cancer treatment. CONCLUSIONS: Younger patients, those with stomas, and those suffering from diarrhea or constipation are more likely to report poor health-related quality of life at six-week follow-up. The routine measurement of health-related quality of life using an instrument that includes a patient-rated scale together with condition-specific items could be used to detect patients at risk of poorer short-term health-related quality of life outcomes.