Factors associated with long-term functional outcomes and participation in patients with colorectal cancers.

The study had no control group and was cross-sectional, so it cannot show that any factor caused poorer outcomes. Only 100 of 540 patients in the centre database consented, and participants were community-dwelling survivors not receiving active treatment, so the findings may not represent all colorectal cancer patients. Rectal cancer was overrepresented, and the authors suggest selection bias because rectal cancer patients may have been more willing to participate. The study did not measure pre-diagnosis function, socioeconomic status, cultural factors, or a minimum time after discharge, which limits interpretation of long-term outcomes. The methods describe a Bonferroni adjustment for some comparisons, but the limitations state that no correction for multiple comparisons was applied, so the handling of multiple tests is unclear. The measures did not capture issues outside their domains, although recall bias was reduced by assessing current status and checking records.

The authors declared no conflicts of interest. Funding came from internal resources of the Rehabilitation Department at Peter MacCallum Cancer Centre and Royal Melbourne Hospital.

Do not read the generally good quality-of-life scores as evidence that colorectal cancer survivors need no rehabilitation. Fatigue, pain, bowel and bladder problems, and unmet support needs were common, and this cross-sectional study cannot show what causes them.