OBJECTIVES

The goal of this study was to estimate the frequency of fecal incontinence (FI) and urinary incontinence (UI) diagnoses in patients with rectal cancer (RC).

METHODS

This study included patients aged between 18 and 90 years who had received an initial RC diagnosis and subsequent follow-up in one of 1,203 general practices in Germany (Disease Analyzer database, IQVIA) between January 2000 and December 2017 (index date). After applying similar inclusion criteria, patients without a cancer diagnosis were matched 1:1 to patients with RC based on age, sex, index year, and physician type. The primary outcome of the study was the incidence of fecal and urinary incontinence within five years of the initial RC diagnosis. However, no information on radiotherapy, which may be associated with both kinds of incontinence, was available.

RESULTS

The present study included 3,249 individuals with RC and 3,249 individuals without cancer (mean age: 66.5 years, 57.3% males).

Within five years of the index date, 8.6% of RC patients and 1.3% (p<0.001) of patients without cancer received a FI diagnosis, and 16.7% of RC patients and 5.3% (p<0.001) of patients without cancer received a UI diagnosis. We thus observed a positive association between RC and FI (adjusted hazard ratio [HR]=8.39, p<0.001) and between RC and UI (adjusted HR=3.59, p<0.001). The impact of RC on both FI and UI was stronger in younger patients and male patients.

CONCLUSIONS

In a cohort of almost 6,500 patients, we confirmed that RC is a significant predictor of fecal and urinary incontinence.