Abstract
Rapidly increasing colorectal cancer (CRC) incidence in Malaysia and the introduction of cutting edge new treatments, which prolong survival, mean that treatment outcome measures meed to be evaluated, including consideration of patient's quality of life (QoL) assessment. There are limited data on QoL in CRC patients, especially in Malaysia. Therefore, this study was performed focusing on cancer stages and age groups. The cross sectional study was conducted from June to September 2011 at three public tertiary hospitals with the EORTC QLQ C-30 questionnaire in addition to face to face interview and review of medical records of 100 respondents. The mean age was 57.3 (SD 11.9) years with 56.0% are males and 44.0% females, 62% of Malay ethnicity, 30% Chinese, 7% Indian and 1% Sikh. Majority were educated up to secondary level (42%) and 90% respondents had CRC stages III and IV. Mean global health status (GHS) score was 79.1 (SD 21.4). Mean scores for functional status (physical, emotional, role, cognitive, social) rangeds between 79.5 (SD 26.6) to 92.2 (SD 13.7). Mean symptom scores (fatigue, pain, nausea/vomiting, constipation, diarrhea, insomnia, dyspnoea, loss of appetite) ranged between 4.00 (SD 8.58) to 20.7 (SD 30.6). Respondents role function significantly deteriorates with increasing stage of the disease (p=0.044). Females had worse symptoms of pain (p=0.022), fatigue (p=0.031) and dyspnoea (p=0.031). Mean insomnia (p=0.006) and diarrhea (p=0.024) demonstrated significant differences between age groups. QOL in CRC patients in this study was comparable to that in other studies done in developed countries. Pain, fatigue and dyspnoea are worse among female CRC patients. Given that functions deteriorates with advanced stage of the disease at diagnosis, a systematic screening programme to detect cases as early as possible is essential nationwide.
Highlights
Colorectal cancer (CRC) is one of the most common cancer in the world
Assessment of colorectal cancer patients quality of life is important for patients as well as to the clinicians because the results can guide patients to the treatment options while informed decision making can be made by the clinician
We obtained a 100% response rate among respondents who willingly participated in the EORTC QLQ C-30 questionnaire
Summary
Colorectal cancer (CRC) is one of the most common cancer in the world. It is the third most common cancer in United Kingdom (Cancer Research UK, 2010) as well as in the United States of America (Jemal et al, 2008). The increasing trend of colorectal cancer incidence in Asia and many other economic transition countries (Center et al, 2009) prompt a more effective screening programme as well as comprehensive treatment of CRC which includes consideration of patient’s quality of life. In Malaysia, currently the awareness of the importance of CRC screening is very low especially among the general population as well as the policy makers which resulted in inadequate resources allocation for faecal occult blood test and colonoscopy and subsequently late stage of the disease at presentation. The paradigm of outcome in colorectal cancer treatment for the past decade has slowly shifted towards improvement of patients’ quality of lives, besides survival and disease free survival. Quality of life it is a subjective perception of cancer patients’ symptoms, function and side effects
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