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HRQoL Low Among Young Adult Colorectal Cancer Survivors

February 04, 2021


Kimberly Miller, PhD, MPH, University of Southern California Keck School of Medicine, Los Angeles, discusses results from a study exploring health-related quality of life (HRQoL) in colorectal cancer survivors who were diagnosed before age 50.

These results were presented at the virtual 2021 ASCO Gastrointestinal Cancers Symposium.


My name is Kimberly Miller. I'm an associate professor of preventive medicine at the Keck School of Medicine at the University of Southern California in Los Angeles.

I'm talking about the abstract recently presented at the ASCO Gastrointestinal Cancer Symposium 2021 entitled "Health‑Related Quality of Life and Time from Diagnosis Among Young Adult Colorectal Cancer Survivors."

We wanted to examine quality of life in young colorectal cancer survivors. By that, we mean those diagnosed under age 50. Incidence of colorectal cancer has been steeply increasing in this young patient population, and little is known, actually, about their quality of life.

In partnership with a national patient advocacy organization, the Colon Club, we conducted a cross‑sectional survey of 235 young adult colorectal cancer survivors, and we used the Functional Assessment of Cancer Therapy or the FACT‑C which is specific to colorectal cancer to examine their quality of life.

Both globally and across the specific domains, emotional, physical, social, and functional, what we call role/function, their ability to function and do everyday activities. What we did first of all was to look overall to see what their quality of life was across the domains globally.

What we found was that it was actually quite low. Out of a total range of 0 to 136, globally, these young survivors scored around 68. Within each domain, their quality of life scores were also quite low. In terms of the literature, low in comparison to those who were older, ages 60 and over.

Then what we did was we stratified by time from diagnosis. Because this was cross‑sectional, we did not have longitudinal data. We wanted to try to find out, as you're farther from diagnosis, does your quality of life increase?

Are young adult survivors actually adjusting to and coping with their disease? We stratified the sample from 6 to 18 months post‑diagnosis, and then 19 to 36 months. We looked at mean scores and compared them.

What we found was that it was the case that, for the survivors were farther from diagnosis, that their emotional and their physical and their functional quality of life scores were significantly higher, compared to those who were more recently diagnosed, but that was not the case, by contrast, for social quality of life, or social well‑being.

For those who were farther from diagnosis, their social well‑being was significantly lower than those closer. Overall, what we take from this study is, first of all, that this at‑risk young adult group has low quality of life.

It's an area where targeting counseling, age‑appropriate interventions are needed. Specifically, it appears that social well‑being is an area which is not recovering, and in fact, is often an area that's not really clinically screened. It's not an area that we were paying attention to clinically.

We know from years of study, we have evidence, that social relationships and social connections are very important for health outcomes, and specifically so for young adults, and young adults with a cancer diagnosis.

Overall, our recommendation and our takeaway from this is that target interventions, patient counseling and support is needed, and specifically looking into social well‑being and providing supportive services that respond to helping patients and survivors socially connect, perhaps, with others. Thank you very much.

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