Modifiable and fixed factors predicting quality of life in people with colorectal cancer

Nicola Mary Gray, Susan Jane Hall, Susan Browne, Una Macleod, Elizabeth Mitchell, Amanda Jane Lee, Marie Johnston, S. Wyke, Leslie Samuel, D Weller, Neil Crawford Campbell

Research output: Contribution to journalArticlepeer-review

73 Citations (Scopus)


People with colorectal cancer have impaired quality of life (QoL). We investigated what factors were most highly associated with it.
Four hundred and ninety-six people with colorectal cancer completed questionnaires about QoL, functioning, symptoms, co-morbidity, cognitions and personal and social factors. Disease, treatment and co-morbidity data were abstracted from case notes. Multiple linear regression identified modifiable and unmodifiable factors independently predictive of global quality of life (EORTC-QLQ-C30).
Of unmodifiable factors, female sex (P<0.001), more self-reported co-morbidities (P=0.006) and metastases at diagnosis (P=0.036) significantly predicted poorer QoL, but explained little of the variability in the model (R2=0.064). Adding modifiable factors, poorer role (P<0.001) and social functioning (P=0.003), fatigue (P=0.001), dyspnoea (P=0.001), anorexia (P<0.001), depression (P<0.001) and worse perceived consequences (P=0.013) improved the model fit considerably (R2=0.574). Omitting functioning subscales resulted in recent diagnosis (P=0.002), lower perceived personal control (P=0.020) and travel difficulties (P<0.001) becoming significant predictors.
Most factors affecting QoL are modifiable, especially symptoms (fatigue, anorexia, dyspnoea) and depression. Beliefs about illness are also important. Unmodifiable factors, including metastatic (or unstaged) disease at diagnosis, have less impact. There appears to be potential for interventions to improve QoL in patients with colorectal cancer.
Original languageEnglish
Pages (from-to)1697-1703
Number of pages7
JournalBritish Journal of Cancer
Early online date10 May 2011
Publication statusPublished - 24 May 2011


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