Symptom Experiences in Colorectal Cancer Survivors After Cancer Treatments: A Systematic Review and Meta-analysis.
Claire J Han, Gee S Yang, Karen Syrjala
PMID 32000174WHAT IT FOUND
After colorectal cancer treatment, survivors most often reported body image distress (78.5%).
Fatigue was the most severe symptom (50.1 on a 0-100 scale). Nurses can use these findings to assess and manage long-term survivorship symptoms.
Key findings
01In the combined estimates, body image distress was the most frequent symptom (78.5%), followed by peripheral neuropathy (61.8%).
02Fatigue was the most severe symptom (50.1 on a 0-100 scale), followed by insomnia (39.9) and body image distress (36.4).
03Worse symptoms were associated with female sex, younger age, stage III or IV disease, oxaliplatin-based chemotherapy, having a stoma, low education, low self-efficacy, being unmarried or single, comorbidities, and poor physical or social functioning.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were cross-sectional, so the review can describe associations but cannot show what caused the symptoms. Symptom measurement varied widely across studies, including different tools, time points and symptom dimensions, so combined estimates should be read as broad summaries rather than precise numbers. The studies varied greatly, so combined results for most symptoms were calculated using methods that allow for differences between studies. The review excluded qualitative studies and studies focused mainly on sexual or urinary symptoms, so those experiences are only partly captured. Most studies were from the United Kingdom or United States, so results may not apply to other healthcare systems or cultures. No study was excluded for low methodological quality, and the quality threshold used was arbitrary. Some symptoms, including cognitive impairment, had too few compatible studies to be combined.
Declared interests
The publication types list NIH extramural research support. The article text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not read the combined symptom percentages as proof that a treatment caused them. This review describes symptoms and associations in survivors after treatment, not tested interventions.