Abstract
BackgroundThe aims of the study were to assess the health preference and health-related quality of life (HRQOL) in patients with colorectal neoplasms (CRN), and to determine the clinical correlates that significantly influence the HRQOL of patients.MethodsFive hundred and fifty-four CRN patients, inclusive of colorectal polyp or cancer, who attended the colorectal specialist outpatient clinic at Queen Mary Hospital in Hong Kong between October 2009 and July 2010, were included. Patients were interviewed with questionnaires on socio-demographic characteristics, and generic and health preference measures of HRQOL using the SF-12 and SF-6D Health Surveys, respectively. Clinical information on stage of disease at diagnosis, time since diagnosis, primary tumour site was extracted from electronic case record. Mean HRQOL and health preference scores of CRN patients were compared with age-sex matched controls from the Chinese general population using independent t-test. Multiple linear regression analyses were conducted to explore the associations of clinical characteristics with HRQOL measures with the adjustment of socio-demographic characteristics.ResultsCross-sectional data of 515 eligible patients responded to the whole questionnaires were included in outcome analysis. In comparison with age-sex matched normative values, CRN patients reported comparable physical-related HRQOL but better mental-related HRQOL. Amongst CRN patients, time since diagnosis was positively associated with health preference score whilst patients with rectal neoplasms had lower health preference and physical-related HRQOL scores than those with sigmoid neoplasms. Health preference and HRQOL scores were significantly lower in patients with stage IV colorectal cancer than those with other less severe stages, indicating that progressive decline from low-risk polyp to stage IV colorectal cancer was observed in HRQOL scores.ConclusionIn CRN patients, a more advanced stage of disease was associated with worse HRQOL scores. Despite potentially adverse effect of disease on physical-related HRQOL, the mental-related HRQOL of CRN patients were better than that of Chinese general population.
Highlights
Colorectal neoplasms (CRN) represent a wide spectrum of disease transition from precancerous colorectal polyps to colorectal cancer
The quality-adjusted life years (QALYs) is calculated by the sum of the life years weighted by the health preference scores, anchoring on a scale from zero to one, of each individual staying at specific health state
The inclusion criteria were that the adults patients had known stage of disease classification based on the colorectal neoplasm screening surveillance guideline[7] and the American Joint Committee on Cancer (AJCC) staging classification system for colorectal cancer[8]: 1) Low-risk polyps group; 2) High-risk polyps group; 3) Stage I; 4) Stage II; 5) Stage III and 6) Stage IV
Summary
Colorectal neoplasms (CRN) represent a wide spectrum of disease transition from precancerous colorectal polyps to colorectal cancer. Significant associations between HRQOL and stage at cancer diagnosis did not exist in colorectal cancer survivors[3,4] but did happen in mixture of survivors and nonsurvivors[5]. The health preference score of colorectal polyp patients is contributed to the economic evaluation that informs health policy making. The health preference of colorectal polyp patients enables the calculation of QALYs to compare no screening against alternative colorectal cancer screening strategies in economics evaluation. The aims of the study were to assess the health preference and health-related quality of life (HRQOL) in patients with colorectal neoplasms (CRN), and to determine the clinical correlates that significantly influence the HRQOL of patients
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