Gastrointestinal Symptoms in Older Female Survivors of Colorectal Cancer - European Medical Journal

Gastrointestinal Symptoms in Older Female Survivors of Colorectal Cancer

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SURVIVORS of colorectal cancer (CRC) often experience long-term symptoms following treatment. However, gastrointestinal (GI) symptoms are relatively under-investigated in survivors of CRC. The research team at the Ohio State University, Columbus, USA, described persistent GI symptoms following cancer treatment in females who had survived CRC. Further analysis permitted the assessment of risk and life-impact factors associated with GI symptoms.

The cross-sectional study utilised data from the Women’s Health Initiative (WHI) LILAC study, which included postmenopausal females. In total, 413 participants were included in the analysis (average age: 71; average age at diagnosis: 63). Cancer had been treated surgically in 63.2% of participants, while 34.4% had received multiple treatments, such as surgery and chemoradiation. Secondary analysis utilised data from questionnaires assessing demographics, GI symptoms, non-GI symptoms, physical activity, and dietary habits, as well as the impact these measures had on quality of life.

Abdominal bloating and gas were the most common GI symptoms reported (54.2%), followed by constipation (44.1% overall, and 12.6% with moderate-to-severe), diarrhoea (33.4% overall, and 10.4% with moderate-to-severe), and abdominal/pelvic pain (28.6% overall, and 6.8% with moderate-to-severe). Overall, 15.4% of survivors reported moderate to severe GI symptoms when all symptoms were combined into a composite score. Further analysis suggested a higher likelihood of reporting persistent GI symptoms was linked with being within 5 years of diagnosis and surviving a Stage III cancer. Finally, the prevalence of anxiety, sleep problems, depression, and fatigue was higher in the GI symptom group than the non-GI symptom group.

Overall, female survivors of CRC experience a high GI symptom burden, even in remission. The research team suggest that their findings will aid in identifying those more vulnerable to symptoms and inform future survivorship care interventions through highlighting multiple risk factors. Further research is needed to examine the underlying biological mechanisms of GI symptoms.

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