[Utilization of inpatient rehabilitation of younger patients with colorectal neoplasms--results of the project "Popgen-colorectal cancer"].
BACKGROUND
Colorectal neoplasms (ICD-10 diagnoses C18-C21) are the second-leading malignancies in Schleswig-Holstein, Germany (women: 17% of all neoplasms, men: 16%) and are the second-leading cause of death when only the cancer-related deaths are taken into account (women: 14%, men: 12%). At time of diagnosis women are 5 years older than men (median: 73 vs. 68 years). Up to now, data on frequency and predictors of utilization of rehabilitation of patients with colorectal neoplasms are not available. Therefore, we evaluated this topic in a population-based cohort of patients with colorectal cancer from Schleswig-Holstein. Data were obtained in the course of the Popgen study.


METHODS
Popgen is a population-based molecular genetic study. For this project younger patients (<65 yrs) with colorectal neoplasms (ICD-10 diagnosis C18-C21) who where living in Schleswig-Holstein and who had received the diagnosis between Jan. 2000 and Sept. 2004, were asked by means of a postal self-administered questionnaire regarding their medical care and quality of life (EORTC QLQ-C30). Eligible study participants were identified in the epidemiological cancer registry of Schleswig-Holstein.


RESULTS
In all, 245 patients participated and sent back the questionnaire (37+/-15 months after receiving the primary diagnosis). Of 241 persons with a valid answer, 119 (49%) participated in medical rehabilitation (62 females and 56 males, Chi (2): p=0.180). The rehabilitation lasted 3.76+/-0.94 weeks, and in 36.7% of the cases the rehabilitation started within two weeks after being discharged from the hospital. In a regression model in which T-category, N-category, gender, age, education, health insurance (private or statutory), living with a partner, stoma, radiation, chemotherapy, complications or side effects of the therapy were included as independent predictors for the utilization of rehabilitation, only the factor "living with a partner" was identified as a significant predictor: patients without a partner more often received inpatient rehabilitation than patients living with a partner (odds ratio=3.8; 95% confidence interval [1.3; 11.7]).


CONCLUSIONS
Colorectal neoplasms are a huge burden for the patients due to therapy and comorbidity. Therefore, colorectal neoplasms are an important indication for attending rehabilitation. About one half of the Popgen study participants took part in inpatient rehabilitation. It still remains to be clarified whether the utilization rate observed indicates adequate medical care or not.
Waldmann
A
A
Institut für Krebsepidemiologie an der Universität zu Lübeck. Annika.Waldmann@krebsregister-sh.de
Lautz
E
E
Hampe
J
J
Schreiber
S
S
Schafmayer
C
C
Katalinic
A
A
D003082:Colectomy / Q000534:rehabilitation*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000534:rehabilitation*; D003125:Colostomy / Q000534:rehabilitation; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care; D011183:Postoperative Complications / Q000534:rehabilitation*; D012959:Socioeconomic Factors; D016896:Treatment Outcome