B194: Trajectories of quality of life, health status and personal wellbeing in the two years following curative intent treatment for colorectal cancer: results from the UK ColoREctal Wellbeing (CREW) cohort study

Claire Foster1,3,Joanne Haviland1,3,Jane Winter2,3,Chloe Grimmett1,3,Kim Chivers Seymour3,Lynn Batehup3,Lynn Calman1,3,Jessica Corner3,Amy Din1,3,Deborah Fenlon3,Christine M May1,3,Peter W Smith4,Alison Richardson2,3

1Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK,2University Hospital Southampton NHS Foundation Trust, Southampton, UK,3Faculty of Health Sciences, University of Southampton, Southampton, UK,4Southampton Statistical Sciences Research Institute, University of Southampton, Southampton, UK

Presenting date: Monday 2 November
Presenting time: 16.50 - 17.05

Background

 

Cancer survivorship is a growing global concern and the current aftercare system does not sufficiently meet patients’ needs.  It is important to understand patterns of recovery in order to tailor aftercare appropriately. We examine trajectories of quality of life (QoL), health status and personal wellbeing in the first two years following colorectal surgery

Method

Prospective cohort study of 872 UK colorectal cancer patients who consented to follow-up. Questionnaires at baseline (pre-surgery), 3, 9, 15, 24 months. QoL (Quality of Life in Adult Cancer Survivors, QLACS), health status (EQ-5D), personal wellbeing (Personal Wellbeing Index), physical symptoms, anxiety, depression, self-efficacy, social support, socio-demographic and clinical/treatment characteristics were examined. Longitudinal analyses assessed change in QoL, health and wellbeing over time and predictors of trajectories

Results

Four distinct trajectories (groups) were identified for each outcome measure. Group 1: consistently good QoL (31.3%), mild and improving health problems (20.9%), consistently good wellbeing (44.9%). Groups 2 and 3 displayed intermediate and changing levels of QoL, health status and personal wellbeing. Group 4: consistently poor QoL (5.3%) and health status (7.4%), very poor/declining wellbeing (4.2%). 11.5% were in Group 4 for at least one of the outcome measures. Factors statistically significantly associated with poorer trajectories: higher deprivation, more comorbidities, stoma, worse physical and psychological symptoms, lower self-efficacy to self-manage and less social support

Conclusion

Results from this large representative study show that distinct recovery trajectories following surgery for colorectal cancer can be identified with risk factors. Different approaches to follow-up care are warranted and these results provide robust data regarding who is likely to need more intensive support, which will inform the development of risk-stratified follow-up management tailored to an individual’s need.  This provides NHS commissioners with cost-effective, comprehensive packages of care for this patient group