Quality of life in survivors of colorectal carcinoma

Assessing health-related quality of life among cancer survivors during systemic and radiation therapy in Bangladesh: a cancer-specific exploration

BACKGROUND

Evaluating the effects of cancer diagnosis and treatment on a patient's overall well-being is crucial and health-related quality of life (HRQoL) is a reliable metric for assessing this impact. Little is known about HRQoL among cancer survivors across various stages and treatments. The study examined individual and clinical factors influencing HRQoL among cancer survivors.

METHODS

A cross-sectional study was conducted in two specialised cancer care hospitals in Dhaka, Bangladesh. Cancer-diagnosed adults receiving treatment at selected hospitals from January to May 2022 were enrolled. The 5-level EuroQol-5 Dimensions version (EQ-5D-5L) instrument was used to collect HRQoL data. HRQoL scores were derived using UK value sets. The investigation used a multivariable Tobit regression model to determine the association between independent variables and HRQoL scores.

RESULTS

A total of 607 adult patients were enrolled, with 55% being females and 66% aged 36 to 64 years. Reported health problems in five EQ-5D domains include mobility (11%), self-care (11%), usual daily activities (19%), pain/discomfort (21%), and anxiety/depression (46%). Patients with throat, brain, lung, blood, and liver cancer had lower utility scores. Advanced-stage cancer survivors had lower utility scores (β = -49 units, 95% codfidence interval [CI]: -0.75 to -0.22) compared to early-stage survivors. Physically inactive survivors had lower utility scores by 0.41 units (95% CI: -0.51 to -0.30) compared to their counterparts. Private hospital patients had higher utility scores, whereas patients belonged to poor socioeconomic groups scored worse than wealthier ones.

CONCLUSIONS

This study highlights the impact of clinical and individual characteristics on HRQoL among cancer survivors. These findings advocate for an enhanced Bangladeshi cancer patient care model through timely interventions or programs, early detection or diagnosis, tailored treatments, and the promotion of physical activity to bolster HRQoL outcomes.

Systematic review of health state utility values for economic evaluation of colorectal cancer

Cost-utility analyses undertaken to inform decision making regarding colorectal cancer (CRC) require a set of health state utility values (HSUVs) so that the time CRC patients spend in different health states can be aggregated into quality-adjusted life-years (QALY). This study reviews CRC-related HSUVs that could be used in economic evaluation and assesses their advantages and disadvantages with respect to valuation methods used and CRC clinical pathways. Fifty-seven potentially relevant studies were identified which collectively report 321 CRC-related HSUVs. HSUVs (even for similar health states) vary markedly and this adds to the uncertainty regarding estimates of cost-effectiveness. There are relatively few methodologically robust HSUVs that can be directly used in economic evaluations concerned with CRC. There is considerable scope to develop new HSUVs which improve on those currently available either by expanded collection of generic measures or by making greater use of condition-specific data, for example, using mapping algorithms.

Assessment of life quality of patients after rectal carcinoma operation

AIM: To evaluate the changes of life quality of patients with rectal cancer before and after operation.

METHODS: The life qualities of 48 patients (Dixon: n = 25; Miles: n = 23) with rectal cancer were assessed using gastrointestinal quality of life index (GIQLI) before and 1, 6, 12 mo after operation.

RESULTS: The mean preoperative GIQLI score of all the patients was 104.21. The scores were 91.97 (P < 0.05), 105.65 (P > 0.05), and 113.95 (P < 0.05), respectively, 1, 6 and 12 mo after operation. The GIQLI score of Dixon's group was slightly lower than that of Miles' group 1 mo after operation (P > 0.05), but significantly higher than 6 and 12 months after operation (107.30 ± 10.57 vs 103.85 ± 11.03, P < 0.05; 116.35 ± 12.64 vs 111.34 ± 13.65, P < 0.05).

CONCLUSION: The life quality of patients with rectal cancer falls in the early period after operation due to the damage of operation and complication, but it is significantly improved in the long period, which is related to the operation style.