Patient reported outcomes after treatment for colon cancer - A nationwide study

Treatment of colon cancer (CC) may induce late side effects that impact patients' quality of life. The aim of this study was to evaluate self-reported health-related quality of life (HRQoL) one year after diagnosis of CC stage I-III for patients treated with curative intent.

The study population included patients registered with a CC diagnosis in the Cancer Registry of Norway in 2019-2020, ≥18 years, and who underwent segmental colon resection, and a control group without colorectal cancer. They participated in the study by completing a survey using validated questionnaires (EORTC QLQ-C30/CR29/CIPN20 and Chronic pain scale).

There were 1490 patients and 1693 controls eligible for analysis. Patients had significantly lower functional scores than controls, but only anxiety differed at a clinically relevant level (difference -10.2, 95% CI -12.0 to -8.4, p < 0.01). Oxaliplatin-based adjuvant chemotherapy was associated with higher neuropathy scores and worse in patients receiving chemotherapy >3 months. Adjuvant chemotherapy with 5-fluorouracil and oxaliplatin >3 months was associated with lower scores for social function, body image, and anxiety. No significant association was observed between adjuvant chemotherapy and fatigue. Major chronic pain was reported by 177 (11.9%) patients, which impaired their HRQoL across several domains.

Overall, patients had lower functional scores than controls, with anxiety being a significant burden. Oxaliplatin-based therapy induced neuropathy, particularly in those treated for over three months, who also reported increased anxiety, reduced body image and social functioning. One out of ten patients had major chronic pain, associated with impaired HRQoL.