Predictive factors associated with health-related quality of life in patients with colorectal cancer in Iran: a cross-sectional study.

Objectives: This study aims to identify the primary factors influencing health-related quality of life (HRQoL) in patients with colorectal cancer (CRC), hypothesising that specific patient characteristics and clinical factors significantly impact HRQoL.

Design: This was a cross-sectional study conducted over 1 month, from 1 April 2022 to 1 May 2022.

Setting: The study was conducted in five hospitals in the northwest region of Iran, focusing on outpatient chemotherapy services.

Participants: A total of 251 patients diagnosed with colon and rectal cancer participated in the study. Inclusion criteria included a confirmed diagnosis by an oncologist, ability to communicate, willingness to participate and being aware of their diagnosis and treatment. Exclusion criteria were the presence of other chronic diseases, cognitive disorders, known mental disorders and unwillingness to participate.

Interventions: No interventions were applied as this was an observational study.

Primary And Secondary Outcome Measures: The primary outcome was the HRQoL of patients with CRC, measured using a standardised SF-36 (36-Item Short Form Health Survey) questionnaire. Secondary outcomes included the impact of demographic and clinical factors on HRQoL.

Results: The total score of HRQoL in these patients is 47.22±16.78, which indicates that HRQoL is disturbed in these patients. Also, the results of the stepwise multiple regression revealed that among all the participants' characteristics considered, seven factors: not having another disease besides cancer (p<0.001, β: 12.91, 95% CI 8.40, 17.42), only receiving chemotherapy (p<0.001, β: 9.10, 95% CI 4.12, 14.09), not having colostomy (p<0.001, β: 10.27, 95% Cl 5.70, 14.84), female sex (p=0.046, β: -4.52, 95% Cl -8.95, -0.08), living in their own house (p=0.001, β: 11.25, 95% Cl 4.77, 17.73), living in city (p=0.002, 17.74, 95% Cl 6.51, 28.96) and finally not having a job (p=0.003, β: -7.47, 95% Cl -12.31, -2.63), including are the factors that have the most predictive power in HRQoL.

Conclusions: The findings of this study encourage health service providers and planners to pay special attention to the characteristics of patients with CRC as identified in this study. Notably, several HRQoL scores in patients with CRC are low, and the study found that patient characteristics, such as the presence of colostomy, unemployment, female gender and comorbidities, significantly predict the overall HRQoL score. Future research should focus on interventional studies aimed at minimising the adverse effects of disease symptoms on HRQoL in these vulnerable patients.