Quality of Life of Colorectal Cancer Patients and Its Association With Anxiety and Depression: Cross-Sectional Study at a Tertiary Care Hospital in Low Middle Income Country

Introduction: Colorectal cancer (CRC) and its therapy profoundly affect the quality of life (QoL) of patients. The emotional distress: anxiety and depression also negatively affect wellbeing of these patients. This study aims to evaluate the QoL, anxiety, and depression in CRC patients and their association with clinic-pathological features at a tertiary care hospital in Karachi Pakistan, a low middle income country. Methods: An analytical cross-sectional study was conducted on adult CRC patients. QoL was assessed using the European Organization for Research and Treatment of Cancer QoL questionnaire C30 and CR29. Hospital Anxiety and Depression Score was used to evaluate the anxiety and depression. Analyses were performed using STATA version 12, including multivariable linear and multivariate analysis of variance. A P value of < 0.05 was considered as significant. Results: A total of 127 CRC patients with mean age of 53 ± 15 y participated. Mean global QoL score was 69.08 ± 1.78. Among symptoms scales: stoma care problem and among functional scales: sexual interest (women > men) were the most significantly affected aspect. Anxiety and depression were seen in 26 (20.9%) and 24 (18.9%) patients, respectively. Lower global QoL was significantly associated with depression (−25.33 [95% confidence interval: −34.4, −16.23]), on adjuvant treatment (−15.14 [−21.84, −8.44]), and neoadjuvant treatment (−11.75 [−19.84, −3.65]). Conclusions: This is the first study assessing the QoL in CRC patients in Pakistan. Depression was found to be significantly associated with poor QoL. Numerous factors correlated with low QoL scores indicating the need to develop local guidelines to address psychological distress in our patients.