The association between comorbidities and the quality of life among colorectal cancer survivors in the People's Republic of China

Ji-Wei Wang,1,* Li Sun,1,2,* Ning Ding,3 Jiang Li,4 Xiao-Huan Gong,1 Xue-Fen Chen,1 Dong-Hui Yu,5 Zheng-Nian Luo,6 Zheng-Ping Yuan,7 Jin-Ming Yu1 1School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 2Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, People’s Republic of China; 3Centre for Research and Action in Public Health, The University of Canberra, Canberra, ACT, Australia; 4Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA; 5College of Clinical Medicine, Anhui Medical University, Hefei, Anhui Province, 6Shanghai Health Education Association, 7Shanghai Cancer Rehabilitation Club, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Cancer survivors with certain comorbidities had lower quality of life (QOL). This study was performed to investigate the prevalence of comorbidities and the association between comorbidities and the QOL among Chinese colorectal cancer survivors (CCS). Methods: A cross-sectional study was conducted among 1,398 CCS between April and July 2013 in Shanghai, People’s Republic of China. All the participants were asked to complete a simplified Chinese version of the European Organization for Research and Treatment quality of life version 3 questionnaire and questions on sociodemographic characteristics and comorbidities. In order to mitigate the bias caused by confounding factors, multiple linear regression models were employed to calculate the adjusted means of QOL scores. Results: The proportion of participants without any comorbidity was only 20.2%. The CCS with comorbidities except hypertension scored significantly lower on the European Organization for Research and Treatment quality of life version 3 questionnaire global health and functioning scales and Functional Assessment of Cancer Therapy-General scales but higher on the European Organization for Research and Treatment quality of life version 3 questionnaire symptom scores, indicating that they had poorer QOL, particularly for cardiovascular, respiratory, digestive, and musculoskeletal diseases. Conclusion: There exists a significant association between comorbidities and QOL among Chinese CCS, and participants with comorbidities generally reported lower QOL scores. These findings suggested comprehensive care for CCS. Keywords: colorectal cancer survivors, quality of life, comorbidities, cancer car