Surviving colorectal cancer: A study of information needs and health-related quality of life.

Abstract

223 Background: Colorectal cancer (CRC) is a life changing process, which impacts survivors’ health-related quality of life (HRQoL). CRC survivors face new uncertainties and have specific information needs. While advances in CRC treatment have increased the number of survivors, little is known about how information needs differ across groups of survivors, or whether information deficits influence HRQoL. Methods: In 2019-2020 we surveyed patients who, in 2014-18, underwent resection of Stage III colorectal cancer and were seen at a community oncology practice, an academic cancer center, or reported to Georgia SEER (51% RR). Patients were asked questions about survivorship, including their need for additional information (NAI) about CRC follow-up care. HRQoL was measured using PROMIS—29+2 Profile v2.1. Patients also self-reported their race and their belief about whether they were cancer free. Associations between patients’ NAI and covariates (including race and belief in being cancer free) were assessed with logistic regression, while associations between HRQoL scores and covariates were assessed with one-way analysis of variance (ANOVA). We used linear regression to assess relationships between NAI and HRQoL. Results: Data from 380 patients were included in these analyses. 44% were > age 65, 84% white, 22% had < high school education, and 32% had a household income of less than $60,000. 55% indicated a need for more information about CRC follow-up care. 90% believed that they were currently cancer free. Black CRC survivors were significantly more likely to report an information need compared to White patients (OR 2.446, 95% CI 1.147-5.217; p = 0.02). Patients who believed they were currently cancer-free were significantly less likely to report an information need compared to patients who did not believe they were cancer-free (OR 0.357, 95% CI 0.169-0.750; p < 0.01). Having a need for additional information was significantly associated with worse HRQoL (difference in mean HRQoL score -0.26, standard error 0.19; p < 0.01). Conclusions: Black CRC survivors were 2.4 times more likely to have an information need than White survivors. Survivors who believed they were currently cancer-free were 35% less likely to have an information need than those who did not share the same belief. Having an information need was associated with worse HRQoL. Tailored survivorship communications and patient education related to managing recurrence risk may help improve HRQoL among CRC survivors.