Colorectal cancer surgery and long-term health related quality of life with remote follow-up

This study investigated the long-term health-related quality of life (HQL) after colorectal cancer (CRC) surgery. Researchers suggested that overall long-term HQL was good, although some patients may need closer follow-up.

CRC is the third most common cancer worldwide. Surgery is the recommended treatment and is associated with a 5-year survival rate of 60.1%. The standard follow-up method involves regular clinic appointments for over 5 years. During these visits, the patients are followed by blood tests and colonoscopy (a tube is inserted in the anus to examine the intestine). It also involves frequent CT scans. These methods are heavy on resources and are associated with increased anxiety in the patients.

There is no need for regular clinic appointments with remote (distant) follow-up. Patients can be followed from their homes which improves the timely delivery of follow-up tests. Prior studies suggested that this method is safe, accepted by the patients, and cost-effective. Patients undergo tests at the appointed time and only go to the clinic if the results are abnormal. However, this method might not address the problems impacting the quality of life of patients.

This study included 428 patients with CRC who received surgery. HQL questionnaires were filled by the participants assigned to remote follow-up. The average time for remote follow-up was 2.6 years.

At follow-up, 26.6.% of patients reported no HQL issues, while 10.7% reported issues in all HQL domains. There were no differences in HQL scores in relation to the original tumor site or the additional therapy received by the patients.

Female patients and patients with a stoma (a bowel is brought out through an opening in the belly) reported significantly lower HQL. Sexual dysfunction and poor body image were reported more often in patients with a stoma. Patients undergoing surgery on the right-side colon reported lower HQL when compared to those with a left-side. 

This study concluded that remote follow-up of patients with colorectal cancer is associated with a good quality of life. 

This study did not consider the presence of other health problems in the participants which could decrease long-term HQL. This might have affected the results.