The association of bowel function, participation in life activities, and quality of life in rectal cancer survivors

Joanna E. Bulkley, Carmit K. McMullen, Andreea M. Rawlings, Robert S. Krouse, Melanie C. Francisco, Andrew T. Sterrett, Andrea N. Burnett-Hartman, Pamala A. Pawloski, Douglas A. Corley, Janice C. Colwell, Heather Spencer Feigelson

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate whether limited participation in life activities is associated with quality of life (QOL) in rectal cancer survivors, and if so, whether this association is independent of bowel function difficulties. Methods: We surveyed rectal cancer survivors from four healthcare systems about their QOL, bowel function, and participation in life activities. Additional demographic and clinical variables were extracted from the electronic health record. We examined independent associations between bowel function, participation in life activities, and QOL, controlling for potential confounders. We also identified factors, including ostomy status, that correlate with participation in life activities. Results: Of the 527 respondents, 52% were male, 80% were non-Hispanic white, and the mean age was 63. In fully adjusted models for all rectal cancer survivors, participation in life activities was positively associated with QOL, while bowel function was not. Bowel function retained an independent association with QOL for those who previously had an ostomy and were therefore more likely to have a low rectal anastomosis. Lower participation in life activities was correlated with lower self-reported physical and cognitive function, younger age, financial difficulty, and being non-Hispanic white. Conclusions: Rectal cancer survivors’ participation in life activities was strongly associated with QOL, even when controlling for numerous confounders, including bowel function. Identifying ways to improve participation in life activities may be critical to developing rehabilitative and other supportive interventions that optimize QOL among rectal cancer survivors.

Original languageEnglish (US)
Pages (from-to)487-495
Number of pages9
JournalQuality of Life Research
Volume31
Issue number2
DOIs
StatePublished - Feb 2022
Externally publishedYes

Keywords

  • Cancer survivors
  • Disability and health
  • International classification of functioning
  • Ostomy
  • Quality of life

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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