Colorectal Cancer and Quality of Life: A Medicare Advantage Study by Race, Ethnicity, and Language.

Abstract

Background and methods: Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016-2020). The exposure group answered "Yes" to the current CRC treatment and the control group answered "No." The primary outcomes were physical component summary (PCS) and mental component summary (MCS) scores. Conditional effects by race and ethnicity were analyzed using interaction terms.

Results: Among 184 486 adults, 676 (0.4%) reported current CRC treatment. Those receiving treatment had significantly lower PCS scores (β coefficient -1.98, p < 0.001) and lower MCS scores (β coefficient -0.81, p = 0.018), compared to nontreatment. In the treatment group, Hispanic respondents and Spanish speakers had higher PCS scores (β coefficient 1.96, p = 0.019 and 3.19, p = 0.023, respectively), and respondents identifying as American Indian or Alaska Native had higher MCS scores (β coefficient 8.72, p = 0.016).

Conclusion: Individuals receiving CRC treatment exhibit worse HRQOL. Outcomes differed by race and ethnicity. This study suggests the need to invest in targeted interventions to improve overall HRQOL during treatment for CRC.