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SOCIO-DEMOGRAPHIC DETERMINANTS OF QUALITY OF LIFE IN RECTAL CANCER PATIENTS IN SRI LANKA Dakshitha Wickramasinghe*, Praveen V. Dayasena, Pragathi L. Weerakkody, Sanjeewa Seneviratne, Dharmabandhu N. Samarasekera Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka Introduction The social determinants of quality of life (QOL) of Sri Lankan colorectal cancer (CRC) patients has not been evaluated before. We present the findings of the first study on the QOL of Sri Lankan CRC patients. Methodology Colorectal cancer patients with stage I - III who underwent treatment with a curative intent at 2 referral centres in Sri Lanka were invited to participate in the study. Participants were recruited at different stages of treatment (e.g. while receiving neo-adjuvant treatment, post-surgical). Translated and validated Sinhala version of the European Organization for research and treatment of cancer (EORTC) QLQ-C30 and QLQ-CR29 questionnaires were administered. Quality of life was compared between 2 sexes, different treatment modalities, stoma and non-stoma patients were calculated. Mann-Whitney and Kruskal-Wallis tests were used to identify statistically significant differences in the QOL among subgroups. Spearman correlation coefficient was used to identify correlations. Results A total of 102 participants (Male: Female 53: 49) were recruited. Their mean age was 57.2 years (SD- 12.0). Twenty-five of them (24.5%) were undergoing neo-adjuvant treatment while the remaining had had surgery at different times. The majority (N=79, 77.5%) were treated for rectal cancer. There was a statistically significant negative correlation with age and body image (Spearman rho -0.22, p=.34), dysuria (rho= -.22, p=.31) and a positive correlation with emotional functioning (rho= .35, p 0.03). Males had a significantly higher score for the blood and mucus (Mann-Whitney U=934, p=.021) and dysuria (U=889.5, p=.004) symptom scales. No other statistically significant associations between age or sex and symptom / function scales were identified. The level of education had a statistically significant association with the anxiety scale (Kruskall-Wallis test, χ2(4)=12.2, p=.016) where anxiety score was higher (better) with increasing education level. In contrast the social functioning scale score decreased (worse) with increasing level of education scale (Kruskall-Wallis test, χ2(4)=14.6, p=.006). Neither the religious beliefs nor their living conditions (own house/rented house/ living with children) had any statistically significant effect on the functional or symptom scales. There was a non-significant association between an income of over LKR 50,000 (approx. USD 325) and a better score in the financial difficulty scale (Kruskall-Wallis test, χ2(3)=7.2, p=.06). Conclusions Certain aspects of QOL worsened with increasing age. Patients with higher education levels appeared less anxious but had poor social functioning. An income of over LKR 50,000 per month was associated with a better QOL. There were no associations with QOL and religious beliefs or living conditions.
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