Prevalence of Long-term Patient-reported Consequences of Treatment for Colorectal Cancer: A Systematic Review

Colorectal cancer (CRC) survivors experience persistent late effects of treatment, 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 synthesize the evidence on the range and prevalence of patient-reported symptoms and functional impairments experienced by CRC survivors in the acute and longterm period following primary treatment for CRC. Evidence Acquisition: We searched the Embase, Pubmed, and 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 synthesized descriptively across different time points (baseline, during treatment, and up to three years post-treatment) to determine the 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 criteria and were included. Three years after primary treatment, up to 55-65% of CRC survivors reported issues with mobility, 40% reported pain and discomfort, and up to 83% reported fecal incontinence. Many patients had impaired sexual and/or urinary function. Conclusion: CRC survivors should be screened for persistent late effects of treatment, assessed with validated patient-reported measures. Appropriate management strategies should be implemented to reduce symptom burden and improve the quality of life of these patients.