Improved identification of risk factors for low health-related quality of life (HRQOL) among colorectal cancer (CRC) survivors is needed. These findings were published in the Journal of Cancer Survivorship.

Cancer and its treatment can lead to long-term symptoms and functional deficits. Most previous studies of long-term outcomes have not included symptoms of physical, social, or cognitive function. To assess HRQOL more broadly, a cohort of 909 CRC survivors were assessed for 8 domains of symptoms to identify risk or protective HRQOL factors.

The study population was 51.5% women; 72.6% had colon cancer; and 39.9% were White, 23.0% Black, 19.3% Hispanic, and 17.7% Asian.

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Correlations among the symptom domains ranged between 0.42 and 0.69. A 4-profile solution to predict subgroups was the best fit; however, a 3-profile solution was more clinically interpretable. In the 3-profile solution, 30% had low HRQOL, 44% moderate HRQOL, and 26% high HRQOL.

Risk for low HRQOL associated with female gender (adjusted odds ratio [aOR], 2.30), Black (aOR, 3.41) or Asian (aOR, 2.81) ethnicity, not working (aOR, 4.04), cardiac-related conditions (aOR, 4.17), mental health conditions (aOR, 8.24), sleep disturbances (aOR, 9.88), and receiving chemotherapy (aOR, 8.12).

Decreased risk for low HRQOL associated with older age at diagnosis (aOR, 0.83 per 5-year increase in age), increased financial well-being (aOR, 0.83 per half standard deviation [SD] in financial well-being score), and spirituality (aOR, 0.51 per half SD in spirituality score).

On the basis of these features, a model accurately predicted patient HRQOL profile in 64.44% of cases.

This study was limited by the prior understanding of how symptoms tended to vary across demographic profiles.

The high proportion of survivors with CRC who belonged to the low HRQOL group (30%) indicated that additional screening tools are needed to better assess for long-term symptoms and functional deficits such that earlier identification and intervention may be possible.


Potosky AL, Graves KD, Lin L, et al. The prevalence and risk of symptom and function clusters in colorectal cancer survivors. J Cancer Surviv. Published online November 17, 2021. doi:10.1007/s11764-021-01123-6