Abstract
Since colorectal cancer (CRC) survivors often suffer from long-term adverse health effects of the cancer and its treatment, having a negative impact on their health-related quality of life (HRQL), this study focuses on the association between adherence to WCRF/AICR recommendations and HRQL among CRC survivors. In a cross-sectional PROFILES registry study in 1096 CRC survivors (mean time since diagnosis 8.1 years), WCRF/AICR adherence scores (range 0–8, with a higher score for better adherence) were calculated, and HRQL was assessed using the EORTC QLQ-C30. Associations between adherence scores and HRQL scores were investigated using linear regression analyses. Additionally, associations with adherence to guidelines for body mass index (BMI) (normal weight, overweight and obese), physical activity (PA) (score 0/1) and diet (score < 3, 3– < 4 and > 4) were evaluated separately. Mean adherence score was 4.81 ± 1.04. Higher WCRF/AICR scores were associated with better global health status (β 1.64; 95%CI 0.69/2.59), physical functioning (β 2.71; 95%CI 1.73/3.68), role functioning (β 2.87; 95%CI 1.53/4.21), cognitive functioning (β 1.25; 95%CI 0.19/2.32), social functioning (β 2.01; 95%CI 0.85/3.16) and fatigue (β − 2.81; 95%CI − 4.02/− 1.60). Adherence versus non-adherence PA was significantly associated with better physical, role, emotional and social functioning, global health status and less fatigue. Except for the association between being obese and physical functioning (β − 4.15; 95%CI − 47.16/− 1.15), no statistically significant associations with physical functioning were observed comparing adherence to non-adherence to BMI and dietary recommendations. Better adherence to the WCRF/AICR recommendations was positively associated with global health status, most functioning scales and less fatigue among CRC survivors. PA seemed to be the main contributor.
Highlights
In 2007, the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) launched the diet and physical activity recommendations for cancer prevention [1]
Our results are in line with the results of Breedveld-Peters et al who found that higher adherence to the total set of WCRF/AICR recommendations was associated with better physical functioning and less fatigue in a small group (N = 145) of Colorectal cancer (CRC) survivors in the Netherlands [12]
Higher adherence to the WCRF/AICR recommendations was associated with better physical, role, cognitive and social functioning, better global health status and less fatigue among CRC survivors
Summary
Cancer survivors, defined as people who are living with a diagnosis of cancer, including those who have recovered from the disease [1], or in other words those who finished treatment and are disease-free, are encouraged to follow these recommendations to reduce risk of recurrence and improve survival. Colorectal cancer (CRC) survivors often suffer from longterm adverse health effects of cancer and its treatment [2]. This can have a negative impact on health-related quality of life (HRQL). Two systematic reviews showed that CRC survivors. Because of the increasing numbers of CRC survivors, investigating possibilities to increase HRQL is very important
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