Afsaneh Barzi, MD, medical oncologist at the City of Hope discusses the ASCO GI 2020 Abstract – Health-related quality of life and time from diagnosis among young adult colorectal cancer survivors.
Context:
The incidence of colorectal cancer (CRC) is growing among patients under 50 years of age. The quality of life of survivors in this population is not well represented. In CRC survivors = 50 years old, who were 6-18 months or 19-36 months from initial diagnosis or relapse, we compared health-related quality of life (HRQoL).
Methodology:
In conjunction with a national association for young CRC survivors, a cross-sectional online survey was conducted. To measure HRQoL, which assesses HRQoL internationally, using a CRC specific scale, and mental, physical, social, and functional well-being domains, the Functional Assessment of Cancer Therapy (FACT-C) was used. To compare HRQoL among survivors who were 6-18 months versus 19-36 months after diagnosis/relapse, T-tests were performed.
Outcomes:
This sample (n=308) had a mean age of 33.76 SD±6.68; 201 (65.3%) were male; the colon or rectal tumor position was 41.7% and 58.3%, respectively. The majority were diagnosed with stage 2 disease (55.23 percent); 98.0 percent were non-metastatic. 42.2% had a relapse; 25% had an ostomy. The majority of survivors were 6-18 months from diagnosis/relapse (N=189; 61.4 percent), and main demographics and disease features did not vary substantially between those who were shorter versus longer from diagnosis/relapse. Out of a total score of 136, the mean global HRQoL score was 67.3. Scores were low across domains, with the highest in social well-being (15.15/28) and the lowest in emotional well-being (11.44/24). Among survivors who were 6-18 months after diagnosis/relapse, social well-being was substantially greater relative to 19-36 months (15.98 for 6-18 months vs. 13.83 for 19-36; p<0.01), as was functional well-being (13.20 for 6-18 months vs. 11.12 for 19-36; p<0.01). Emotional well-being and physical well-being within groups did not vary substantially.
Findings:
For younger CRC survivors, overall HRQoL scores were poor, and social and functional well-being for those longer after diagnosis was substantially worse. In order to manage HRQoL over time in this at-risk population, adequate therapy and other targeted treatments are important.