Patient-Reported Outcomes of Colorectal Cancer Patients in University Malaya Medical Centre

Background: In Malaysia, colorectal cancer is ranked the second most frequent cancer among men and women. Despite that, research on patient-reported outcomes in colorectal cancer is scarce. Aim: This study aimed to determine the pattern and factors affecting health-related quality of life (HRQOL) among colorectal cancer patients treated at the University Malaya Medical Centre (UMMC), Malaysia. Methods: This study is a cross sectional assessment of health-related quality of life of colorectal cancer patients attending UMMC using locally validated Bahasa Malaysia (BM) and Malaysian Chinese versions of the EORTC QLQ-C30 core and colorectal cancer specific EORTC-QLQ-CR29 tools. Data were drawn from patients' records, national registration department and interviews (physical and telephone). Statistical analyses included descriptive, psychometric evaluations and stepwise multiple linear regression models. Results: The reliability and validity of the BM and Malaysian Chinese tools were examined among 189 patients. The questionnaires were acceptable to the patients, with adequate Cronbach's alpha in all but the cognitive function scale, test-retest coefficient were adequate, and all items fulfilled the criteria for convergent and discriminant validity except question number 5 in QLQ-C30 in both the tools. Three hundred and twenty patients not involved in the validation study were surveyed and these patients rated their global health status/quality of life (GHS/QOL) and functional well-being higher than the EORTC reference values and reported fewer symptoms. Ethnicity was associated with the GHS/QOL at univariate level only. Role, social/family functioning scales were the two independent predictors of GHS/QOL and both are modifiable. Conclusion: Proactive engagement of patients to share their experiences with colorectal cancer and its treatment is recommended. Emphasis should be role, social and family functions, which were found to be proxies for the overall GHS/QOL.