Impact of Patient-Related Factors on HRQoL of Colorectal Cancer Survivors With a Permanent Ostomy

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Placement of a permanent fecal stoma following treatment for colorectal cancer has been associated with HRQoL deficits in some patients.
Placement of a permanent fecal stoma following treatment for colorectal cancer has been associated with HRQoL deficits in some patients.

Female gender and younger age are associated with lower health-related quality of life (HRQoL) in patients with a stoma for 6 months or longer after surgery for colorectal cancer, results of a systematic review of 6 studies has shown. This study was published in Supportive Care in Cancer.

Placement of a permanent fecal stoma following treatment for colorectal cancer has been associated with HRQoL deficits in some patients. Nevertheless, there is scant evidence on how patient-related factors, such as age, gender, employment, household income, and education, influence HRQoL in this population of patients.

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Six published studies met pre-established criteria and were included in this systematic review. Five studies were cross sectional in design and 1 was longitudinal; most involved small cohorts of less than 100 patients. There was a high degree of variation with respect to HRQoL measures used across these studies, although all HRQoL measures were validated.  

Lower HRQoL scores in several domains were observed for women compared with men in all studies that investigated gender differences. While 3 studies found no correlation between age and HRQoL, 2 studies showed lower HRQoL in younger compared with older patients, particularly among women. This review did not provide evidence for the influence of socioeconomic factors on HRQoL in colorectal cancer patients with a permanent stoma. Of the 3 included studies that addressed the impact of employment, education, or household income on HRQoL, no correlation was observed.

Potential limitations of this systematic review include the small study cohorts, which may be result of selection or response bias. In addition, publication bias may exist, in that studies finding no correlations may be less likely to be published. 

“We highly encourage more research in this field with well validated stoma-specific HRQoL-instruments preferably with a weighed score and with large cohorts to establish if demographic or socioeconomic factors impact the HRQoL in long-term colorectal cancer survivors with a stoma, and qualitative studies to explore reasons for the presented age and gender differences,” the authors concluded. 

Reference

Kristensen HØ, Thy⌀ A, Christensen P. Systematic review of the impact of demographic and socioeconomic factors on quality of life in ostomized colorectal cancer survivors[published online January 30, 2019]. Support Care Cancer. doi: 10.1080/0284186X.2018.1557785

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