Health-related quality of life trajectories in older adult long-term survivors of colorectal cancer.

Abstract

Purpose: The purpose of this study was to examine factors affecting health-related quality of life (HRQOL) over time in older adult survivors of colorectal cancer (CRC) and determine demographic and clinical characteristics associated with declines in HRQOL.

Methods: This secondary analysis utilized the Surveillance Epidemiology and End Results and Medicare Health Outcomes Survey and included CRC survivors aged 65 or older who completed at least one survey pre-diagnosis and two surveys within ten years post-diagnosis. HRQOL was captured by the Veterans Rand 12-item scale which provides mental and physical composite scores. Group-based trajectory modeling was employed to identify HRQOL trajectories. Multinomial logistic regression predicted group membership based on demographic and clinical characteristics.

Results: The cohort (n = 649) was predominantly female (58%), white (70%), with an average age of 77 years. Most participants were diagnosed at Stage I disease (56%) and underwent surgery (63%). Three groups were identified based on trajectories of MCS: low increasing, medium decreasing, and high stable. Income and comorbidity number predicted MCS group membership. Five groups were identified based on trajectories of PCS: low decreasing, medium stable, steeply decreasing, high decreasing, and high stable. Older age at diagnosis, identifying as Hispanic, and comorbidity number predicted PCS group membership.

Conclusions: Comorbidities, age at diagnosis, ethnicity, and income significantly impact the HRQOL of older adult survivors of CRC. The resources and needs of each patient should be considered in long-term survivorship plans.