title: Functional deficits and symptoms of long-term survivors of colorectal cancer treated by multimodality therapy differ by age at diagnosis.
abstract: BACKGROUND
  With advances in multimodality therapy, colorectal cancer survivors are living longer. However, little is known about the quality of their long-term survival. We investigated the functional outcomes and symptoms among long-term survivors.
  
  
  METHODS
  A cross-sectional study of 1,215 long-term (>5 years) colorectal cancer survivors was conducted using a validated disease-specific questionnaire. Younger onset survivors (18-50 years) were matched 1:2 to later onset survivors (>50 years). Standardized mean scores were compared using one-way ANOVA. Key patient and treatment factors that impact function and symptoms were assessed by multivariate linear regression.
  
  
  RESULTS
  Eight hundred thirty survivors responded at an interval of 10.8 ± 3 years from diagnosis (68% response rate). Younger onset survivors underwent more surgery (97.9 vs. 93.6%, P < 0.001) and received more chemotherapy (86.1 vs. 77.7%, P = 0.004). Anxiety, body image, sexual dysfunction, embarrassment by bowel movements, micturition problems, and impotence were significant concerns. Younger onset survivors reported worse anxiety, body image, and embarrassment with bowel movements, whereas later onset survivors highlighted sexual dysfunction, micturition problems, and impotence. Age at diagnosis was a key independent determinant of long-term function and symptoms.
  
  
  CONCLUSIONS
  Long-term survivors of CRC face ongoing functional deficits and symptoms, and their survivorship experience differs by age. Age at diagnosis should serve as a basis for tailored, personalized survivorship care plans.
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, T. Boone Pickens Academic Tower, 1400 Pressler Street, Unit 1484, P.O. Box 301402, Houston, TX, 77230, USA.
authors.forename: Christina E
authors.initials: CE
authors.lastname: Bailey
authors.forename: Hop S
authors.initials: HS
authors.lastname: Tran Cao
authors.forename: Chung-Yuan
authors.initials: CY
authors.lastname: Hu
authors.forename: George J
authors.initials: GJ
authors.lastname: Chang
authors.forename: Barry W
authors.initials: BW
authors.lastname: Feig
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rodriguez-Bigas
authors.forename: Sa T
authors.initials: ST
authors.lastname: Nguyen
authors.forename: John M
authors.initials: JM
authors.lastname: Skibber
authors.forename: Y Nancy
authors.initials: YN
authors.lastname: You
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003672:Defecation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors