ASPO Abstracts
Title: Does colorectal cancer site influence stress, QoL, and sleep?
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Purpose:
Understanding quality of life (QoL), stress, and sleep quality among colorectal cancer (CRC) patients could
contribute to improved survivorship care.
Methods:
We ascertained QoL, stress, and sleep quality within an ongoing population-based study of 1,451 CRC
patients identified through the Puget Sound SEER cancer registry. We assessed QoL as physical, social,
emotional, and functional well-being using the standardized 36-item Functional Assessment of Cancer
Therapy: Colorectal Cancer (FACT-C). We assessed stress and sleep quality using the standardized Perceived
Stress Score (PSS-10) and components of the Pittsburg Sleep Quality Index, respectively. Differences in QoL,
stress, and sleep quality by CRC site were analyzed using chi-square and ANOVA tests. We used logistic
regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of tumor site
(rectal vs. colon) with QoL score (higher vs. lowest quartile), stress (moderate/high vs. low), and sleep quality.
ORs were adjusted for sex, age at diagnosis, education level, and cancer stage.
Results:
37% of study participants (N=543) had rectal cancer compared to 63% (N=908) with colon cancer. The study
participants were diagnosed with localized (37%), regional (43%), and distant (18%) cancer stage. Participants
with rectal (vs. colon) cancer were more likely to have low FACT-C (OR [CI]: 1.46 [1.13-1.88]), as well as low
individual physical, emotional, functional, and CRC-related well-being scores. Compared to colon cancer
cases, rectal cancer cases reported trouble sleeping due to getting up to use the bathroom (OR [CI]: 1.52
[1.19-1.94]) and pain (OR [CI]: 1.51 [1.11-2.06]). There were no significant differences between rectal and
colon cancer cases in terms of social well-being scores (FACT-C component), perceived stress, amount of
sleep, and other sleep issues.
Conclusions:
Overall, rectal cancer patients had poorer QoL and sleep quality, and higher perceived stress compared to
colon cancer patients. This suggests that survivorship care may be adapted according to CRC site to ensure
patients receive appropriate support.
Keywords: QoL, stress, sleep, colorectal cancer, survivorship