الفهرس 
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Abstract
Cancer is a disease in which a group of abnormal cells grow beyond their usual
boundaries that can then invade adjoining parts of the body and/or spread to other organs
(metastases). Other common terms used are malignant tumours and neoplasms. Cancer can
affect almost any part of the body and has many anatomic and molecular subtypes that
each require specific management strategies.(1)
Colorectal cancer (CRC) is the third most common cancer worldwide after lung and
breast, with nearly 1.4 million new cases diagnosed in 2012. Colorectal is the third most
commonly occurring cancer in men and the second most commonly occurring cancer in
women, about two thirds of colorectal cancer cases occur in countries characterized by
high or very high indices of development and/or income.(2)
A population-based study in Garbiah, Egypt has shown high rates of CRC in patients
aged 40 years and younger. These rates were slightly higher than rates of the same age
group in the United States (16). In Egypt, low rates of CRC (6.9/100,000 for males and
5.1/100,000 for females) were reported by the Middle East Cancer Consortium in the
period of (1999)-(2001) (17). Also, low rates were reported from Garbiah Cancer Registry
in Egypt for period from (2000)-(2002); age standardized incidence rates (ASRs) were
6.5/100,000 for males and 4.2/100,000 for females (16).
Cancer and its treatment have a major impact on patients‟ lives leading to difficulties
in: fulfilling family roles; the ability to work; participating in common social activities.
Even when successfully treated, cancer may result in long-term physical and psychological
consequences all of these affect QOL. The European organization for research and
treatment of cancer (EORTC) recognize that there is not only a need to examine the impact
of cancer in terms of longer survival, but also in terms of understanding the general effect
of cancer on a patient as a “whole person”, as opposed to simply regarding the patient as a
disease that needs to be cured. This type of research is called health related quality of life
(HRQOL). (34)
Understanding the QoL experienced by colorectal cancer patient is essential for
evaluating the full impact of the disease on individuals, their families and their
communities. Patient perspective is essential in establishing a proper understanding of the
quality of life of colorectal cancer patients. Well-designed oncological studies are of
importance for a profound understanding of the impact on treatment outcome in terms of
QoL. It can be expected to contribute to an individualization of oncological treatment and
thereby an improvement of oncological care. (37)
Aim of the work
The aim of this work is to assess colorectal cancer patients’ quality of life and
recognize the factors affecting it in Alexandria, Egypt.
Subjects and methods
This study was a cross sectional study.The study was conducted on Colorectal cancer
patients admitted to:
Summary and Conclusion
55
Alexandria Cancer Registry and its feeding hospitals: Alexandria Main university
Hospital and Health Insurance Hospitals (governmental).
Alexandria Ayadi Al-Mostakbal Oncology Centre (AAA-OC) (A nongovernmental
oncology centre).
The eligible patients were selected from medical records till achieving the required
sample of 130 patients.
The selected patients were interviewed to fill in the questionnaire
The data collection form included the followings:
Socio-demographic characteristics
Clinical and Pathological characteristics
European Organization for Research and Treatment of Cancer Quality of Life
questionnaire The Arabic version of C30 (EORTC QLQ-C30)
European Organization for Research and Treatment of Cancer Quality of Life
questionnaire (Arabic version) EORTC QLQ-CR29. (Colorectal cancer-specific
module).
The study was exploratory and therefore largely descriptive statistically.
Quantitative data was summarized by mean and standard deviation. Qualitative data
were summarized by using frequency and percent.
Calculating the quality of life scores for EORTC QLQ-C30 and EORTC QLQ-CR29 .
Bivariate analysis was performed using appropriate test; Independent sample t-tests and
analysis of variance One way Anova were used to normally distributed variables and
Mann Whitney test and Kruskal–Wallis test for non-normally distributed variables to
compare the sociodemographic and clinico- pathological characteristics with the quality
of life scores for EORTC QLQ-C30 and EORTC QLQ-CR29.
Multilinear regression analysis was conducted to assess the independent contribution of
different sociodemographic and clinic-pathological characteristics of patients.
The most important findings in our study were:
In present study results of EORTC QLQ C30 showed impaired global health status of
colorectal carcinoma patients with mean value 41.4±20.7
The functional scales of EORTC QLQ C30 showed that most affected functions were
emotional, physical, social, and role functions while the most preserved function was
cognitive function.
The symptom /item scales of EORTC QLQ C30, financial difficulties were the worst
affected symptom with mean value 58.58±28.86.
Summary and Conclusion
56
Stoma and non-stoma patients have almost the same impaired global health status,
stoma patients were found to have higher scores (worst) than non-stoma patients in
financial difficulties.
Stoma patients had worse outcomes in some symptoms such as stool frequency, urinary
incontinence, flatulence, faecal incontinence, sore skin, and embarrassment.
There was no statistically significant difference between men and women in terms of
global QoL.
Younger patients with colorectal cancer express financial and cognitive problems
compared with older patients.
Patients with different marital status had the same poor global Qol.
Rural patient‟s financial difficulties were worse than urban patients.
Some functional scales were worse in obese patients compared to normal weight
patients. These outcomes were statistically significant in physical, social, role functions,
and sexual interest in women.
Obese patients had worse outcomes in some symptoms such as stoma care problems,
flatulence with stoma bag, sore skin with stoma bag, embarrassment with stoma bag.
Patients with different stages and grades were having poor overall global Qol with
no statistically significant difference.
Global health status, physical, role, and emotional functions scores were higher in
educated patients compared to non-educated patients.
Regarding predictors of quality of life scores, educational level and treatment were the
statistically significant predictors of the global quality of life score, physical, role, and
emotional scores of the QLQ-C30. Stoma use, age, and metastasis were important
predictors of cognitive scores of the QLQ-C30. Age, stag III, residence and treatment
were also important predictors for social scores.
Conclusion:
The present study showed that average global health score was generally low. Patients with
stoma suffered worse symptoms scales than those without stoma.