Abstract
Aims. Some quality indicators of proper health care in patients with
colorectal cancer have been established. Our goal was to evaluate the
outcomes of performing certain procedures or treatments, included as
quality indicators, in the follow-up of colorectal cancer patients.
Methods. This was a prospective cohort study of patients diagnosed with
colorectal cancer who underwent surgery and were followed at 1, 2, 3 and
5 years. CT scanning, colonoscopy, chemotherapy and radiotherapy were
evaluated in relation to various clinical outcomes and PROM changes over
five years. Multivariable generalized linear mixed models were used to
evaluate their effect on mortality, complications, recurrence, and PROM
changes (HAD, EQ-5D, EORTC-Q30) at the next follow-up. Results. CT
scanning or colonoscopy was related to a decrease in the risk of dying,
while chemotherapy at a specified moment was related to an increased
risk. In the case of recurrence, CT scanning and chemotherapy showed
statistically increased the risk, while all the procedures and
treatments influenced complications. Regarding PROM scales, CT scanning,
colonoscopy and radiotherapy showed statistically significant results
with respect to an increase in anxiety and decrease in quality of life
measured by the EORTC. However, undergoing radiotherapy at a specified
moment increased depression levels, and overall, receiving radiotherapy
decreased the quality of life of the patients, as measured by the
EuroQol-5d. Conclusions. After adjustment for sociodemographic factors,
comorbidities and severity of the disease, performing certain quality
indicators of proper health care in patients with colorectal cancer was
related to less mortality but higher adverse outcomes.