Factors Influencing Health Related Quality of Life of Colorectal Cancer Patients at University Teaching Hospital of Kigali

Abstract

Background Colorectal cancer is the third most common cancer worldwide. If diagnosed and treated early, the survival rate is fair even in resource-poor settings like Rwanda. We aimed to study the health-related quality of life (HRQoL) of adult survivors of colorectal cancer who were operated on at University Teaching Hospital of Kigali (CHUK) between January 2018 and December 2021. Methods This was a cross-sectional case series study including adults’ patients operated on for colorectal cancer at CHUK. Quality of life information was collected using the EORTC QLQ-C30 and CR29 validated questionnaires. Using Stata Version 16, descriptive statistics were generated, and parametric or non-parametric tests were performed to compare the dimensions of the quality of life of participants, disaggregated by socio-demographic and clinicopathological variables. Logistic regression analysis was used to determine factors associated with HRQoL. A P-value <0.05 was considered statistically significant. Results A total of 145 patients were enrolled. The mean age was 58.08 years and 74 (51%) were male, 46 (31.72%) had advanced clinical disease, 34 (23.45%) had comorbidities, 137 (94.48 %) underwent open surgery, and 51 (35.86 %) had a stoma. On EORTC QLQ-C30 and EORTC QLQ-CR29 participants reported good quality of life with a mean global health status score of 63% (SD: 20.11). Significant differences in mean GHS/QoL scores were observed among education (P-Value = 0.013), neo-adjuvant chemotherapy (PValue = 0.0014), and post-operative chemotherapy (P-Value: 0.0017), and stoma groups. Patients reported overall poor sexual functioning; with men doing better than women (mean scores 34.67 and 40.95 respectively). Having comorbidity was associated with significantly lower physical (P-Value = 0.001), role (P-Value =0.0019), emotional (P-Value =0.0032), and cognitive (P-Value = 0.0001) functioning scores, and significantly higher symptom score of fatigue (P-Value = 0.0001), dyspnea (PValue = 0.001), insomnia (P-Value = 0.0001), and abdominal pain (P-Value = 0.0006). Patients who had surgery at early clinical stage reported better physical functioning (0.043), lower fatigue (P-Value = 0.0228) and better body image (P-Value = 0.047) scores. Patients with a stoma had more nausea and vomiting (P-Value = 0.0177), and pain (P-Value = 0.0362) than patients without stoma. Logistic regression analysis found that neo-adjuvant chemotherapy significantly affected the post-operative HRQoL.