Predictors of impaired quality of life among colorectal cancer survivors: a cross-sectional study

TL;DR

This study identifies tumor stage and having a stoma as key factors that reduce quality of life in colorectal cancer survivors.

Contribution

The study provides new insights into specific predictors of impaired quality of life in colorectal cancer survivors using validated questionnaires in an Arabic-speaking population.

Findings

Tumor stage and stoma presence were the most significant predictors of poor quality of life.

Advanced tumor stage correlated with a 4.88-unit decrease in global health status scores.

Stoma was linked to a 22-fold reduction in social function scores.

Abstract

Comprehensive research on the specific factors affecting the quality of life (QOL) of patients with colorectal cancer (CRC) is lacking. We investigated patient factors affecting QOL in this population.

We conducted a cross-sectional study at Dr. Suliman Fakeeh Hospital, a private tertiary center in Jeddah City, KSA. We used the validated Arabic versions of the Cancer Quality of Life Questionnaire-30 (QLQ-30) and Colorectal Cancer Quality of Life Questionnaire-29 (QLQ-CR29) in patients with CRC. We used a generalized linear model to analyze the data. Significant linear correlations between functional and symptom scores and 11 factors, including age, sex, tumor site and stage, comorbidities, surgery type/approach, leaks, stoma, and neoadjuvant or adjuvant therapy, were detected.

A total of 104 participants answered the survey. The mean global health score was 72.43 (95% confidence interval [CI] 68.18–76.52). Cognitive and physical function scored highest and lowest on the QLQ-30, with a mean of 76.92 (95% CI 71.47–81.73) and 24.92 (95% CI 65.57–74.61), respectively. The worst symptom was insomnia, with a mean of 42.30 (95% CI 36.21–48.71). The most distressing symptoms on the QLQ-CR29 were stoma embarrassment and bloating, with a mean of 41.34 (95% CI 24.67–58.01). Tumor stage and stoma were the two most significant factors for predicting poor QOL. The factors influencing impotence and male libido included age, tumor stage, comorbidities, and the use of chemoradiotherapy.

A one-unit increase in tumor stage was correlated with a 4.88-unit decrease in the global health status score, whereas a stoma was linked to a 22-fold reduction in social function scores. Advanced tumor stage and the presence of a stoma significantly affected patients’ functional status and symptoms.

The online version contains supplementary material available at 10.1186/s41687-025-00971-5.