Background Contemporary literature suggests that advanced cancer negatively impacts quality-of-life (QOL). Few studies have (1) examined how QOL changes in colorectal cancer (CRC) patients over the first 12 months of treatment from diagnosis and (2) compared longitudinal QOL between patients with earlier (stage I, II) versus advanced (stage III, IV) disease.

Methods 227 CRC patients were recruited at diagnosis and followed up until 12 months post-surgery. Patients completed the EORTC Core Quality of Life Questionnaire (EORTC QLQ-C30) at baseline, 1-month, 3-month, 6-month, and 12-month. Demographic and clinical data were extracted from electronic medical records.

Results 111 (48.9%) patients had advanced CRC. The advanced CRC group was younger (mean age 65.9 versus 69.2 years; p<0.05) and the majority needed chemotherapy (N=91; 82.0%) compared to the earlier CRC group. Advanced CRC patients generally experienced lower global QOL, physical, role, and social functioning after the 1-month timepoint compared to earlier CRC. However, multilevel mixed-effects tobit regression suggested that CRC staging was not significantly associated with change in QOL scores over time in any of the QLQ-C30 subscales.

Conclusions CRC patients with advanced disease may not necessarily experience poorer QOL than those with earlier-stage cancer. QOL over the treatment course is likely to be influenced by baseline QOL; further mixed-methods approaches should explore pre-existing patient factors indicating impaired QOL.