Surviving colorectal cancer : patient-reported symptoms 4 years after diagnosis

The number of long-term survivors after a cancer diagnosis is increasing, yet relatively few studies have addressed survivors' reported symptoms beyond the initial year after diagnosis.

The symptom reports of 474 survivors of colon and rectal cancer from 5 US metropolitan areas were collected during 2002-2003 as part a larger study of the quality of care for patients with cancer diagnosed in 1998. The relation between the prevalence of reported symptoms and prior treatments received was analyzed, adjusting statistically for other patient characteristics.

Sixty-nine percent of the survivors had colon cancer and 31% had rectal cancer. The most commonly reported symptoms were "fatigue" (23%), "negative feelings about body appearance" (14%), "diarrhea" (13%), and "constipation" (7%). Higher percentages of respondents attributed health effects to cancer or its treatment including "worry about health" (24%), "physical discomfort" (19%), and "activity limitations" (15%). In general, prior treatment was not associated with symptom prevalence. However, radiation therapy recipients and patients that received a diverting ostomy were more likely than others to report some of the symptoms we studied. Attribution of health effects to disease or treatment did not vary by prior treatment except that recipients of radiation therapy were more likely than others to report limitations in their activities (30% vs 10%; P = .003).

Among colorectal cancer survivors the prevalence of symptoms at 4 years was low and relatively comparable to published estimates for the general population, but some survivors continue to attribute health effects to cancer or its treatment.