177Physical functional limitations and psychological distress in people with and without colorectal cancer

Background This study aims to quantify physical disability and psychological distress in people with and without colorectal cancer (CRC). Methods Questionnaire data (2006-2009) from 267,153 Australian general population members aged ≥45 years participating in the 45 and Up Study (n = 213,231 following exclusions) were linked to cancer registry and hospital admission data, to ascertain CRC status. Modified Poisson regression estimated adjusted prevalence ratios (PRs) for physical disability and psychological distress in participants with versus without CRC. Results Compared with participants without CRC (n = 210,836), CRC survivors (n = 2,395) had significantly higher disability prevalence (11.9% versus 19.5%, respectively): PR = 1.11 (95%CI=1.03-1.20); and a similar prevalence of distress (23.1% versus 20.2%): PR = 1.03 (0.94-1.20). Adverse outcomes were associated with certain clinical characteristics. Compared to participants without CRC, CRC survivors diagnosed 5-<10 and ≥10 years, with regional spread and without recent cancer treatment had similar outcomes; survivors with metastatic CRC and recent treatment had 30-60% higher prevalence of disability and distress. Compared to participants with neither CRC nor disability, PRs for distress were 4.71 (4.22-5.26) for those with disability and CRC and 4.22 (4.13-4.31) for those with disability without CRC. Conclusions Physical disability is elevated in CRC survivors. Psychological distress is elevated 4- to 5-fold with disability, regardless of CRC diagnosis, with lesser increases around diagnosis and treatment. Key message CRC survivors with less advanced disease and who have not been recently diagnosed or treated have physical disability and psychological distress comparable to the general population. Survivors with disability are at particularly high risk of distress.