Quality of life and the negative impact of comorbidities in long-term colorectal cancer survivors: a population-based comparison

J Cancer Surviv. 2020 Oct;14(5):653-659. doi: 10.1007/s11764-020-00876-w. Epub 2020 May 11.


Purpose: Colorectal cancer (CRC) is the third most common cancer in the USA. The objective of this study was to compare quality of life (QoL) across long-term colorectal cancer survivors and unaffected matched controls while adjusting for comorbidities.

Methods: The National Cancer Institute (NCI)-funded Colon Cancer Family Registry (CCFR) was used to randomly select and recruit CRC survivors (≥ 5 years from diagnosis) and matched controls for a cross-sectional survey. Nine geographically diverse sites in the USA from the CCFR participated in the study. Telephone interviews were conducted using computer-assisted methods to assess QoL.

Results: A total of 403 cases and 401 controls were included in the final sample. Unadjusted comparison revealed no significant difference between CRC survivors and controls with respect to measures of fatigue, social, emotional, functional, and physical well-being. Multivariate logistic regression revealed that case status had a significant negative influence on colorectal cancer-specific QoL measures. Higher comorbidity indices had a significant negative influence on overall QoL regardless of case status.

Conclusions: Quality of life among long-term CRC survivors is similar to control subjects, with the exception of worse CRC-specific QoL measures. Higher comorbidity indices were independently associated with poor QoL for both cases and controls.

Implications for cancer survivors: Survivors and healthcare providers should be aware that long-term QoL is comparable to the general population; however, there is potential that digestive tract-specific issues may persist.

Keywords: Colon cancer; Colorectal cancer; Global quality of life; Long-term survivorship; Quality of life.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cancer Survivors / psychology*
  • Case-Control Studies
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / psychology*
  • Colorectal Neoplasms / therapy
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Registries / statistics & numerical data*
  • United States / epidemiology