Perception of cure and quality of life in anal cancer survivors

Anal cancer is treated with chemoradiotherapy and with salvage surgery in case of local failure. Curation rate depends on tumour stage but is overall high (80-90%). This study explored anal cancer survivors' perception of being cured and possible association with Quality of Life (QoL). Secondary aims were to explore fear of recurrence and if perception of cure changed over time or differed depending on tumour stage.

The ANal CAncer study comprises a cohort of patients diagnosed with anal cancer in Sweden between 2011 and 2013 (n = 388). Participants filled out a study-specific questionnaire 3 and/or 6 years after diagnosis (n = 205). In this sub-study, only patients treated with curative intent were included. The association between perception of cure and QoL was analysed using logistic regression. Descriptive analyses were performed regarding secondary aims.

A high proportion (80%) of the patients were either moderately or very sure of cure across all tumour stages, in both early and advanced tumour stages, and with no obvious improvement over time. Despite this 42% experienced fear of recurrence 6 years after diagnosis. A strong perception of cure was correlated with high QoL.

Even though most patients had a perception of being cured, several patients irrespective of tumour stage, felt unsure of cure and feared recurrence years after successful treatment. A strong perception of cure was also shown to be associated with a high QoL. We suggest that improved counselling could enhance the patient's perception of cure and to possibly improve QoL.