Abstract
PurposeTo assess the effects of dietary and physical activity (PA) interventions on generic and cancer-specific quality of life (QoL), anxiety, and depression levels among adult Chinese colorectal cancer (CRC) survivors.MethodsTwo-hundred twenty-three adult CRC survivors within 1 year of completion of primary cancer treatment were randomized to receive dietary, PA or combined intervention, or usual care for a 12 monthduration, under a 2 (diet vs usual care) × 2 (PA vs usual care) factorial design. Generic and cancer-specific QoL was assessed using a Chinese version 12-Item Short Form Health Survey (SF-12) and the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale, respectively. Anxiety and depression was assessed using the Hospital Anxiety and Depression Scale at baseline, 6, 12, 18, and 24 months. Linear mixed models were used for examining the intervention effects.ResultsParticipants receiving dietary intervention experienced a significant improvement in the generic measure of QoL (SF-6D utility scores, mean difference 0.042, 95%CI 0.03 to 0.081) at 12 months, the cancer-specific QoL scores (mean difference 3.09, 95%CI 0.13 to 6.04), and levels of depression (P = 0.015) at both 12 and 24 months follow-up. Participants receiving PA intervention only demonstrated a significant improvement in SF-6D utility index (mean difference 0.039, 95%CI 0.002 to 0.077) and physical functioning (mean difference 2.85, 95%CI 1.00 to 4.70) at 6 months.ConclusionsDietary intervention improved the generic and cancer-specific QoL and depression in CRC survivors.Trial registrationThe study was prospectively registered on 17 October 2012 at ClinicalTrials.gov (NCT01708824).Implications for Cancer SurvivorsCRC survivors can benefit from dietary interventions in alleviating depression and improving overall health-related QoL.
Highlights
Colorectal cancer (CRC) is a leading burden of disease worldwide
This paper reports on the effects of interventions on generic and CRC-specific quality of life (QoL), levels of anxiety, and depression
The present study adds to our understanding of the role that dietary interventions play on the health-related QoL and levels of anxiety and depression in CRC survivors
Summary
Colorectal cancer (CRC) is a leading burden of disease worldwide. CRC was the third most common cancer in men and the second most common cancer in women with over 1.8 million new cases, accounting for 10.1% of total cancer burdens, in 2018 [1]. The burden of CRC is expected to increase by 60% with more than 2.2 million new cases by 2030 [2]. CRC is the most common cancer in Hong Kong with 5635 new cases in 2017. Cancer survivors report greater mental health needs, higher levels of anxiety and depression, and poor physical and mental health-related QoL [4, 5]. With advances in cancer detection and treatment, CRC survivors are living longer. This underscores the need for finding effective ways to improve both the short-term and long-term health-related QoL and mental health of CRC survivors
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