Prevalence of long-term patient-reported consequences of treatment for colorectal cancer: a systematic review

Abstract

Aim: Colorectal cancer (CRC) survivors experience persistent late effects of treatments, including a range of symptoms and functional impairments. There is limited evidence on the prevalence of such problems in CRC survivors. We conducted a systematic review to synthesise the evidence on the range and prevalence of patient-reported symptoms and functioning impairments experienced by CRC survivors in the acute and long-term period following their primary treatment for CRC. Method: We searched MEDLINE, Embase, Pubmed, Cochrane electronic databases (from 2000 to April 2021) to identify studies reporting longitudinal prevalence (i.e. a minimum of two assessment time-points) of any patient-reported outcomes (PROs) at 12 months or more since treatment. Two reviewers independently screened and extracted data on study characteristics and PRO prevalence. PROs were synthesised descriptively across time-points, from baseline before treatment, during treatment and up to 3-years post-treatment to determine prevalence of PROs over time and the extent of persistent problems in long-term post-treatment survivorship. Results: Of 5587 studies screened, 29 met eligibility and were included. Three years after primary treatment, up to 55-65% of colon cancer survivors reported issues with mobility and 40% reported pain and discomfort. Fecal incontinence was reported by up to 83% of rectal cancer survivors. High prevalence of problems with sexual and urinary function were also reported. Conclusion: Persistent late effects of treatment, assessed with validated patient-reported measures, should be screened for early in post-treatment survivorship to detect problems and refer to appropriate management strategies to reduce symptom burden and improve quality of life of CRC survivors.

Keywords

• bowel cancer
• systematic review
• treatment effects
• patient-reported outcomes
• survivorship