OBJECTIVES : Colorectal cancer (CRC) is the third most diagnosed cancer in both men and women, with a progressive increase in its prevalence in the United States (US). The objective of this review was to identify and summarize the recent evidence on Quality of Life (QoL) and instruments used to measure QoL in patients with CRC in the US.

METHODS : A targeted literature search of English language publications was performed for last five years in MEDLINE via PubMed. The outcomes of interest were QoL, functional status (FS), and patient-reported outcome measures (PROMs) used.

RESULTS : The review identified 80 articles which examined the QoL in the US. The most commonly used PROMs to collect QoL and FS were EORTC QLQ-C30, EORTC QLQ Colorectal Cancer, FACT-C, FACT Colorectal Cancer Symptom Index (FCSI-9), EQ-5D and Veterans RAND 12 Item Health Survey (VR-12). The utility weights for localized disease ranged from 0.40-0.74, and 0.19-0.61 for regional/distant disease, showing decline with growing disease. The utility index fell with the stage/progression of the disease, 0.80 in progression free state to 0.21 in progressive state. The health-state utilities in CRC patients consistently decreased by line of treatment from 0.76 in 1L, 0.65-0.75 in 2L, 0.68 in 3L, to 0.47 in 4L and 0.35 in palliative care. Physical component summary and mental component summary scores were significantly lower in CRC patients when compared to the general US population. The greatest decrements were observed in physical health domain and in stage III and IV patients. Factors associated with poor QoL were disease recurrence, older age, female sex, low income, obesity, smoking, co-morbidity.

CONCLUSIONS : The findings from this study suggested declining utilities with increasing stages of CRC. Further research is suggested to examine the interventions aimed at improving QoL in CRC and the choice of disease-specific tool to capture the patient reported outcomes.