Research Article| Volume 42, ISSUE 12, P1848-1857, August 2006

Restrictions in quality of life in colorectal cancer patients over three years after diagnosis: A population based study


      Despite the burden and prevalence of colorectal cancer (CRC), there is only limited information regarding quality of life of patients who have survived beyond the first year post treatment. We assessed quality of life in a population-based cohort of 309 patients with CRC from Saarland (Germany) one and three years after diagnosis using the QLQ-C30 questionnaire and the tumour specific module QLQ-CR38. When compared with reference data from the general population, most patients with CRC reported high overall quality of life and only small deficits in physical functioning but deficits in emotional and social functioning persist over years in patients with colorectal cancer. Improvements in quality of life from the first to the third year after diagnosis in patients who remained free of disease were very modest and limited to less financial difficulties, a better future perspective and fewer stoma-related problems.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to European Journal of Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Brenner H.
        Long-term survival rates of cancer patients achieved by the end of the 20th century: a period analysis.
        Lancet. 2002; 360: 1131-1135
        • Anthony T.
        • Jones C.
        • Antoine J.
        • Sivess-Franks S.
        • Turnage R.
        The effect of treatment for colorectal cancer on long-term health-related quality of life.
        Ann Surg Oncol. 2001; 8: 44-49
        • Mosconi P.
        • Apolone G.
        • Barni S.
        • Secondino S.
        • Sbanotto A.
        • Filiberti A.
        Quality of life in breast and colon cancer long-term survivors: an assessment with the EORTC QLQ-C30 and SF-36 questionnaires.
        Tumori. 2002; 88: 110-116
        • Ramsey S.D.
        • Berry K.
        • Moinpour C.
        • Giedzinska A.
        • Andersen M.R.
        Quality of life in long term survivors of colorectal cancer.
        Am J Gastroenterol. 2002; 97: 1228-1234
        • Rauch P.
        • Miny J.
        • Conroy T.
        • Neyton L.
        • Guillemin F.
        Quality of life among disease-free survivors of rectal cancer.
        J Clin Oncol. 2004; 22: 354-360
        • Trentham-Dietz A.
        • Remington P.L.
        • Moinpour C.
        • Hampton J.M.
        • Sapp A.L.
        • Newcomb P.A.
        Health-related quality of life in female long-term colorectal cancer survivors.
        Oncologist. 2003; 8: 342-349
        • Forsberg C.
        • Cedermark B.
        Well-being, general health and coping ability: 1-year follow-up of patients treated for colorectal and gastric cancer.
        Eur J Cancer Care. 1996; 5: 209-216
        • Schag C.A.
        • Ganz P.A.
        • Wing D.S.
        • Sim M.S.
        • Lee J.J.
        Quality of life in adult survivors of lung, colon and prostate cancer.
        Qual Life Res. 1994; 3: 127-141
        • Schmidt C.E.
        • Bestmann B.
        • Kuchler T.
        • Longo W.E.
        • Kremer B.
        Impact of age on quality of life in patients with rectal cancer.
        World J Surg. 2005; 29: 190-197
        • Arndt V.
        • Merx H.
        • Stegmaier C.
        • Ziegler H.
        • Brenner H.
        Quality of life in patients with colorectal cancer one year after diagnosis compared to the general population: a population-based study.
        J Clin Oncol. 2004; 22: 4777-4784
        • Aaronson N.K.
        • Ahmedzai S.
        • Bergman B.
        • et al.
        The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.
        J Natl Cancer Inst. 1993; 85: 365-376
        • Sprangers M.A.
        • te Velde A.
        • Aaronson N.K.
        The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life.
        Eur J Cancer. 1999; 35: 238-247
        • Fayers P.M.
        • Aaronson N.
        • Bjordal K.
        • Curran D.
        • Groenvold M.
        • Group obotEQoLS
        The EORTC QLQ-C30 scoring manual.
        second ed. European Organization for Research and Treatment of Cancer, Brussels1999
        • Schwarz R.
        • Hinz A.
        Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population.
        Eur J Cancer. 2001; 37: 1345-1351
        • Osoba D.
        • Rodrigues G.
        • Myles J.
        • Zee B.
        • Pater J.
        Interpreting the significance of changes in health-related quality-of-life scores.
        J Clin Oncol. 1998; 16: 139-144
        • Michelson H.
        • Bolund C.
        • Nilsson B.
        • Brandberg Y.
        Health-related quality of life measured by the EORTC QLQ-C30 – reference values from a large sample of Swedish population.
        Acta Oncol. 2000; 39: 477-484
        • Manderbacka K.
        • Lundberg O.
        Examining points of reference of self-rated health among Swedish oldest old.
        Arch Gerontol Geriatr. 1996; 23: 47-60
        • Vinokur A.D.
        • Threatt B.A.
        • Vinokur-Kaplan D.
        • Satariano W.A.
        The process of recovery from breast cancer for younger and older patients. Changes during the first year.
        Cancer. 1990; 65: 1242-1254
        • Klemm P.
        • Miller M.A.
        • Fernsler J.
        Demands of illness in people treated for colorectal cancer.
        Oncol Nurs Forum. 2000; 27: 633-639
        • Wenzel L.B.
        • Fairclough D.L.
        • Brady M.J.
        • et al.
        Age-related differences in the quality of life of breast carcinoma patients after treatment.
        Cancer. 1999; 86: 1768-1774
        • Camilleri-Brennan J.
        • Steele R.J.
        The impact of recurrent rectal cancer on quality of life.
        Eur J Surg Oncol. 2001; 27: 349-353
        • Bloom J.R.
        • Stewart S.L.
        • Chang S.
        • Banks P.J.
        Then and now quality of life of young breast cancer survivors.
        Psychooncology. 2004; 13: 147-160
        • Sultan S.
        • Fisher D.A.
        • Voils C.I.
        • Kinney A.Y.
        • Sandler R.S.
        • Provenzale D.
        Impact of functional support on health-related quality of life in patients with colorectal cancer.
        Cancer. 2004; 101: 2737-2743
        • Lewis W.G.
        • Holdsworth P.J.
        • Stephenson B.M.
        • Finan P.J.
        • Johnston D.
        Role of the rectum in the physiological and clinical results of coloanal and colorectal anastomosis after anterior resection for rectal carcinoma.
        Br J Surg. 1992; 79: 1082-1086
        • Ramsey S.D.
        • Andersen M.R.
        • Etzioni R.
        • et al.
        Quality of life in survivors of colorectal carcinoma.
        Cancer. 2000; 88: 1294-1303
        • Sprangers M.A.
        • Taal B.G.
        • Aaronson N.K.
        • te Velde A.
        Quality of life in colorectal cancer. Stoma vs. nonstoma patients.
        Dis Colon Rectum. 1995; 38: 361-369
        • Pachler J.
        • Wille-Jorgensen P.
        Quality of life after rectal resection for cancer with or without permanent colostomy.
        Cochrane Database Syst Rev. 2004; : CD004323
        • Camilleri-Brennan J.
        • Steele R.J.
        Quality of life after treatment for rectal cancer.
        Br J Surg. 1998; 85: 1036-1043
        • DeCosse J.J.
        • Cennerazzo W.J.
        Quality-of-life management of patients with colorectal cancer.
        CA Cancer J Clin. 1997; 47: 198-206
        • Engel J.
        • Kerr J.
        • Schlesinger-Raab A.
        • Eckel R.
        • Sauer H.
        • Holzel D.
        Quality of life in rectal cancer patients: a four-year prospective study.
        Ann Surg. 2003; 238: 203-213
        • Bekkers M.J.
        • van Knippenberg F.C.
        • van Dulmen A.M.
        • van den Borne H.W.
        • van Berge Henegouwen G.P.
        Survival and psychosocial adjustment to stoma surgery and nonstoma bowel resection: a 4-year follow-up.
        J Psychosom Res. 1997; 42: 235-244
        • Fayers P.M.
        • Machin D.
        Quality of life assessment analysis and interpretation.
        John Wiley & Sons Ltd., Chichester2000
        • Moinpour C.M.
        • Sawyers Triplett J.
        • McKnight B.
        • et al.
        Challenges posed by non-random missing quality of life data in an advanced-stage colorectal cancer clinical trial.
        Psychooncology. 2000; 9: 340-354
        • Hjermstad M.J.
        • Fayers P.M.
        • Bjordal K.
        • Kaasa S.
        Using reference data on quality of life – the importance of adjusting for age and gender exemplified by the EORTC QLQ-C30 (+3).
        Eur J Cancer. 1998; 34: 1381-1389
        • Hjermstad M.J.
        • Fayers P.M.
        • Bjordal K.
        • Kaasa S.
        Health-related quality of life in the general Norwegian population assessed by the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire: the QLQ = C30 (+ 3).
        J Clin Oncol. 1998; 16: 1188-1196
        • Klee M.
        • Groenvold M.
        • Machin D.
        Quality of life of Danish women: population-based norms of the EORTC QLQ-C30.
        Qual Life Res. 1997; 6: 27-34
        • Fayers P.M.
        Interpreting quality of life data: population-based reference data for the EORTC QLQ-C30.
        Eur J Cancer. 2001; 37: 1331-1334