Colorectal cancer (CRC) continues to be a profound global health challenge, ranked as the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths worldwide. The disease not only imposes a severe burden on mortality rates but also significantly compromises patients’ quality of life, encompassing their physical, psychological, and social well-being. In regions like Ethiopia, where healthcare infrastructure and cancer research are still evolving, there has been a glaring dearth of localized evidence regarding the quality of life among colorectal cancer patients. Addressing this gap, a recent comprehensive study conducted at Tikur Anbessa Specialized Hospital in Addis Ababa sheds new light on the lived experiences of CRC patients within an Ethiopian context, revealing pivotal insights with broad implications for cancer care delivery.
This groundbreaking research utilized a cross-sectional study design to systematically evaluate the quality of life of 159 colorectal cancer patients attending the hospital’s cancer center between February and April 2019. Importantly, the study leveraged the validated Amharic versions of two internationally recognized questionnaires: the European Organisation for Research and Treatment of Cancer Core 30 (EORTC QLQ-C30) and the colorectal cancer-specific module (EORTC QLQ-CR29). These instruments are widely used in oncological research to quantify multiple dimensions of health-related quality of life among cancer patients, encompassing physical functioning, symptom burden, emotional well-being, and social interactions.
The findings uncovered a distressingly low overall health status score among the patients, with a mean global health status score of just 52.88 on a scale where higher values denote better quality of life. This quantitative evidence paints a picture of significant suffering and diminished well-being within this patient population. Notably, the median duration since diagnosis was 12.5 months, indicating these individuals were navigating the complex challenges of cancer both in the immediate post-diagnosis period and beyond, where long-term treatment effects and symptom management become increasingly important.
Delving deeper, the study pinpointed several factors that positively correlated with better quality of life outcomes. Employment status emerged as a significant variable, with employed patients showing over threefold higher odds of experiencing good quality of life (AOR = 3.41). This suggests that economic stability and the ability to participate in work-related activities may serve as protective factors, potentially mitigating some of the psychosocial and financial stresses induced by the illness. Early-stage clinical diagnosis was another robust predictor of favorable outcomes, emphasizing the critical need for timely detection and intervention in CRC to preserve patients’ functional status and life satisfaction.
Physical and social functioning also featured prominently in the quality of life equation. Incremental improvements in physical functioning scores exhibited a positive association with overall well-being, underscoring the substantial impact of mobility, self-care ability, and physical independence on life quality. Similarly, enhanced social functioning, reflecting patients’ capacity to maintain relationships and social roles, contributed beneficially to their perceived quality of life. These findings align with existing literature emphasizing the multidimensional nature of cancer survivorship, where physical health, emotional resilience, and social connections intertwine.
Conversely, the study identified several determinants linked to poorer quality of life among the CRC patients. Gender proved to be a significant factor, with female patients exhibiting markedly lower odds of experiencing good quality of life (AOR = 0.16). This gender disparity may stem from complex socio-cultural dynamics, differential symptom experiences, or barriers in accessing supportive care services that disproportionately impact women. Financial difficulties, as measured by reported economic hardship, also detrimentally influenced patients’ quality of life. For many in low-resource settings, the cost of cancer treatment, diagnostic procedures, and supportive care may impose insurmountable burdens, leading to psychological distress and undermining treatment adherence and outcomes.
Symptom burden emerged as a critical dimension in quality of life assessment, with the presence of blood and mucus in stool correlating significantly with diminished quality of life (AOR = 0.94). Such symptoms likely exacerbate both physical discomfort and psychological distress, signaling disease progression or complications that warrant urgent clinical attention. The complex interplay between disease symptoms, psychological health, and social support emerges clearly from these findings, illuminating avenues for holistic patient-centered interventions.
Importantly, the study’s detailed statistical approach using binary logistic regression allowed for adjusting confounding variables and provided robust effect estimates with confidence intervals. Employing a p-value threshold of less than 0.05 for significance strengthened the rigor of the conclusions. While the study’s cross-sectional nature limits causal inference, it nonetheless offers essential baseline data to inform targeted interventions and future longitudinal research trajectories.
The implications of these findings extend beyond academic insights, speaking directly to healthcare providers, policymakers, and cancer advocacy groups in Ethiopia and comparable low- and middle-income countries. Addressing the multifaceted needs of colorectal cancer patients will require integrated strategies encompassing early detection programs, enhanced access to affordable care, psychosocial support services, and gender-sensitive approaches. Furthermore, mitigating financial toxicity through policy reforms and social safety nets could profoundly improve life quality and therapeutic outcomes.
From a clinical perspective, symptom management, particularly addressing bleeding and stool abnormalities, should be prioritized and integrated into routine cancer care protocols. Physical rehabilitation and social support initiatives may also boost physical and social functioning, thereby elevating overall well-being. Tailored interventions aimed at unemployed patients and those in advanced disease stages are critically needed, given their heightened vulnerability to poor quality of life.
This seminal Ethiopian study also shines a spotlight on the vital role of culturally adapted assessment tools in cancer research. Implementing Amharic versions of the EORTC QLQ questionnaires ensured that the data collected were both linguistically accessible and culturally relevant, enhancing the validity and applicability of the results. Expanding such efforts to other regional languages and cancer types could catalyze broader improvements in cancer survivorship research and care quality across the continent.
In sum, colorectal cancer remains a formidable public health adversary with profound implications for patients’ quality of life, especially in resource-constrained settings. This study’s revelations about the intertwined influences of employment status, disease stage, gender, financial hardship, and symptomatology provide a nuanced understanding that could inform transformative changes in patient care. As Ethiopia continues to strengthen its cancer control programs, integrating quality of life metrics and patient-centered approaches will be essential to advancing holistic, equitable cancer care.
Looking ahead, future research should explore longitudinal changes in quality of life to capture the dynamic trajectories experienced by colorectal cancer patients throughout treatment and survivorship. Additionally, qualitative studies may offer deeper insights into patients’ lived experiences, coping mechanisms, and unmet needs, enriching the quantitative findings reported here. Collaborative efforts involving clinicians, researchers, patients, and communities will be paramount in driving innovations that enhance not only survival but also the well-being of those affected by colorectal cancer globally.
This study’s pioneering contribution demonstrates that improving the quality of life for colorectal cancer patients is an achievable yet complex goal requiring multidimensional action. It invites stakeholders to rethink cancer care beyond traditional biomedical paradigms, embracing holistic, culturally informed, and socially responsive frameworks that honor the full humanity of patients navigating this challenging disease.
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Subject of Research: Quality of life among colorectal cancer patients in Addis Ababa, Ethiopia
Article Title: The quality of life of colorectal cancer patients attending the cancer center in Addis Ababa, Ethiopia
Article References:
GebreLibanos, H., Taye, G., Wondimagegnehu, A. et al. The quality of life of colorectal cancer patients attending the cancer center in Addis Ababa, Ethiopia.
BMC Cancer 25, 754 (2025). https://doi.org/10.1186/s12885-025-14122-y
Image Credits: Scienmag.com
DOI: https://doi.org/10.1186/s12885-025-14122-y
Tags: cancer care delivery in Ethiopiacancer research in developing countriescolorectal cancer burden in Ethiopiacolorectal cancer patient experiencesEORTC QLQ-C30 questionnaireEORTC QLQ-CR29 moduleEthiopian healthcare challengeslocalized evidence in oncologyphysical health in colorectal cancerpsychological well-being in cancer patientsquality of life in colorectal cancersocial well-being and cancer
