Document Type : Systematic Review or Meta Analysis
Faculty of Science, School of Psychology, Quality of Life Office, University of Sydney, Sydney, Australia
Faculty Medicine and Health, Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Sydney, Australia
Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
Faculty of Medicine and Health, Discipline of Surgery, University of Sydney, Sydney, Australia Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia
Faculty of Science, School of Psychology, Quality of Life Office, University of Sydney, Sydney, Australia Faculty Medicine and Health, Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Sydney, Australia
Aim: Colorectal cancer (CRC) survivors experience persistent late effects of treatments, including a range of symptoms and functional impairments. There is limited evidence on the prevalence of such problems in CRC survivors. We conducted a systematic review to synthesise the evidence on the range and prevalence of patient-reported symptoms and functioning impairments experienced by CRC survivors in the acute and long-term period following their primary treatment for CRC.
Method: We searched MEDLINE, Embase, Pubmed, Cochrane electronic databases (from 2000 to April 2021) to identify studies reporting longitudinal prevalence (i.e. a minimum of two assessment time-points) of any patient-reported outcomes (PROs) at 12 months or more since treatment. Two reviewers independently screened and extracted data on study characteristics and PRO prevalence. PROs were synthesised descriptively across time-points, from baseline before treatment, during treatment and up to 3-years post-treatment to determine prevalence of PROs over time and the extent of persistent problems in long-term post-treatment survivorship.
Results: Of 5587 studies screened, 29 met eligibility and were included. Three years after primary treatment, up to 55-65% of colon cancer survivors reported issues with mobility and 40% reported pain and discomfort. Fecal incontinence was reported by up to 83% of rectal cancer survivors. High prevalence of problems with sexual and urinary function were also reported.
Conclusion: Persistent late effects of treatment, assessed with validated patient-reported measures, should be screened for early in post-treatment survivorship to detect problems and refer to appropriate management strategies to reduce symptom burden and improve quality of life of CRC survivors.