الملخص الإنجليزي
Background: As the number of colorectal cancer survivors increases due to advances in
cancer therapy and the implementation of screening programmes, it has become essential
to understand and assess the quality of life (QOL) of cancer survivors after the completion
of treatment, particularly as the side-effects of such treatment can often have severe
physical, mental, and emotional consequences for affected patients. To the best of the
author's knowledge, this is the first study conducted in Oman to assess the QOL of cancer
survivors. The aim of this study was to evaluate QOL and identify factors affecting QOL
among adult Omani colorectal cancer patients who had survived a minimum of six months
following the completion of cancer therapy.
Methods: A cross-sectional study was conducted at the Sultan Qaboos University
Hospital and National Oncology Centre of the Royal Hospital, Muscat, Oman. A total of
124 Omani adult patients with colorectal cancer who had survived six months or longer
after the completion of treatment were recruited. Data collection was conducted between
August 2020 and February 2021. Relevant data were collected from the patients'
electronic medical records. In addition, two self-administered Arabic versions of
questionnaires originally developed by the European Organization for Research and
Treatment of Cancer (EORTC) to determine QOL among patients with general cancer
and colorectal cancer, respectively, were adapted for use in the population. Overall, the
questionnaires incorporated 59 items to determine the most distressing aspects of the
patients' QOL under functional and symptom-related subscales. Scoring for each item
was determined out of 100 according to the EORTC scoring manual, in which high scores
for the functioning subscales indicated better functionality, whereas high scores for the
symptom subscales indicated more severe and distressing symptoms. Subsequently, a
linear logistic regression analysis was used to determine factors predictive of QOL.
Results: A total of 118 out of 124 adult Omani colorectal cancer patients agreed to take
part in the study (response rate: 95.2%). The mean age was 52.7 ± 11.77 years (range:
26–80 years) and there was an equal number of male and female participants. The mean
score for global health status was 81.7. The highest scores in the functioning subscales
were obtained in the domains of role and social functioning (91.0 and 90.7, respectively).
For the general cancer symptoms subscale, the highest mean scores were observed for
constipation and insomnia (25.4 and 25.1, respectively), indicating that these symptoms
were considered most distressing by participants, with 11.0% of the patients complaining
of severe constipation and insomnia. In particular, men reported lower mean scores for
sexual interest in the functional subscale compared to women (31.4 versus 62.2).
Moreover, the highest score among men in the colorectal cancer-specific symptoms
subscale was impotence (35.9), with 16% of male patients complaining of severe
impotence. A total of 12 patients (10.2%) reported severe anxiety. Overall, age, gender,
the presence of comorbidities, and a diagnosis of colon and rectal cancer rather than
colorectal junction were found to be significant predicators of QOL (P ≤0.05 each).
Conclusion: This study showed that the overall QOL of Omani colorectal cancer
survivors was satisfactory, although certain deficits were identified in specific QOL
domains and symptoms. Thus, it is important for healthcare providers in Oman to conduct
regular assessments of colorectal cancer survivors after cancer treatment and implement
an individualised care plan for each survivor. Moreover, the findings of this study suggest
that more effective communication between patients and healthcare providers might be
helpful in order to allow survivors to more clearly express their concerns and experiences;
in addition, offering and referring patients for specialty counselling services could
contribute positively to improving the QOL of colorectal cancer survivors after recovery.
