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Aim: Patients treated with right‐sided hemicolectomy for colon cancer may suffer from long‐term bowel dysfunction, including loose stools, urgency and faecal incontinence. The underlying causes are poorly understood. The aim of this case–control study was to investigate the aetiology of chronic loose stools among patients with right‐sided hemicolectomy curatively operated for cancer. Method: Cases with chronic loose stools (Bristol stool type 6–7) after right‐sided hemicolectomy were compared with a control group of patients with right‐sided hemicolectomy without loose stools. All patients underwent a selenium‐75 homocholic acid taurine (SeHCAT) scan to diagnose bile acid malabsorption (BAM) and a glucose breath test to diagnose small intestinal bacterial overgrowth (SIBO). Gastrointestinal transit time (GITT) was assessed with radiopaque markers. In a subgroup of patients, fibroblast growth factor 19 (FGF19) was measured in fasting blood. SIBO was treated with antibiotics and BAM was treated with bile acid sequestrants. Results: We included 45 cases and 19 controls. In the case group, 82% (n = 36) had BAM compared with 37% (n = 7) in the control group, p < 0.001. SIBO was diagnosed in 73% (n = 33) of cases with chronic loose stools and in 74% (n = 14) of controls, p = 0.977. No association between BAM and SIBO was observed. GITT was similar in cases and controls. No difference in median FGF19 was observed between cases and controls (p = 0.894), and no correlation was seen between FGF19 and SeHCAT retention (rs 0.20, p = 0.294). Bowel symptoms among cases were reduced after treatment. Conclusion: BAM and SIBO are common in patients having undergone right‐sided hemicolectomy for cancer. Chronic loose stools were associated with BAM but not with SIBO. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to translate and validate the chronic pain score (CP score) in a cohort of colon cancer patients. Chronic pain following colon cancer surgery is still poorly understood, in particular the lack of a validated tool for measuring chronic pain is a major issue as such an instrument is critical for evaluating the incidence and risk factors. The CP score was created using data from Danish rectal cancer patients. Methods: Danish colorectal cancer survivors diagnosed between 2001 and 2014 completed the CP score and two quality of life (QoL) measures. Clinical data were obtained from a national database. Convergent validity was investigated by testing the association of the CP score with a single ad hoc QoL item and the EORTC QLQ‐C30, and discriminative validity was tested as the score's ability to differentiate between gender and age groups. Sensitivity and specificity were evaluated by determining the ability of the score to identify patients with a major impact of pain on QoL. Results: Responses from 7127 colon cancer were included. Convergent validity was confirmed, as the score was associated with both QoL measures (p < 0.001). Moreover, the score could differentiate between males/females and older/younger patients (p < 0.001, respectively), reflecting high discriminative validity. Finally, the score was able to identify patients with a major impact on QoL, with a sensitivity of 87% and specificity of 82%. Conclusion: The CP score is a valid tool for measuring chronic pain after colon cancer surgery and should be used to homogenize outcomes in future studies. [ABSTRACT FROM AUTHOR]

The biggest problem currently is that REDCap cannot be integrated with our clinical electronic patient records, official registries etc., and hence data must be manually transferred from the database into the patients' files. It is likely that many of these comorbid patients who have survived treatment of a cancer will be motivated for an intervention of their underlying comorbidity and that this will lead to improved long-term outcome. The aim of follow-up after treatment for colorectal cancer (CRC) is twofold. In our opinion, there is a need to evaluate in randomized trials whether a systematic post-treatment management of patients with increased comorbidity can improve the long-term outcome. [Extracted from the article]

Aim: The aim of the present pilot study was to describe the type and frequency of long‐term gastrointestinal symptoms within a well‐defined cohort of colon cancer survivors, their wish for clinical evaluation and treatment outcomes. Method: A screening survey was sent to colon cancer survivors 12, 24 and 36 months after surgery. Based on their main symptoms, patients who wished to have a consultation were referred to the gastroenterological or surgical unit of our late cancer sequelae clinic. Treatment effect was monitored by questionnaires on bowel symptoms and the EuroQol five‐dimensional (EQ‐5D) quality‐of‐life score. Results: Overall, 953 patients who had survived colon cancer received the screening survey and 767 replied (response rate 80.5%). Of these, 76 (9.9%; 95% CI 7.9%–12.2%) were referred for algorithm‐based clinical evaluation and treatment of bowel dysfunction. The majority were women (69.7%) who had undergone a right‐sided colonic resection (65.8%). Patients reported various symptoms, mainly including urgency, fragmented defaecation, loose stools and incontinence for liquid stools. Patients with emptying difficulties and low anterior resection syndrome‐like symptoms were referred to the surgical unit and patients with diarrhoea were referred to the gastroenterological unit for clinical work‐up. Our main endpoint, mean EQ‐5D index after treatment, was improved compared with baseline (baseline 0.809, after treatment 0.846; p = 0.049). After treatment, self‐rated bowel function and several bowel symptoms were improved as well. Conclusion: This study highlights the importance of identifying colon cancer survivors in need of treatment of late gastrointestinal sequelae and clinical management in a multidisciplinary team setting. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to test the feasibility of a new method for systematic screening for late sequelae (LS) following colorectal cancer treatment. Method: Patients with colorectal cancer from five Danish hospitals were invited to complete a survey about LS at 3, 12, 24 and 36 months after surgery as part of their follow‐up. The survey consisted primarily of validated tools, supplemented by a few ad hoc items, measuring bowel, urinary and sexual dysfunction, pain and quality of life and an additional question regarding request for contact. Patients completed surveys electronically or on paper. Results: Of the 1721 invited patients, 1386 (80.5%) were included (1085 with colon cancer and 301 with rectal cancer) of whom 72.5% responded electronically. Patients responding electronically were 7.6 years younger than those responding on paper (P < 0.001). Since some patients answered more than once, the dataset consisted of 2361 surveys. Patients with colon cancer requested phone contact in 19.0% of the surveys, and 8.4% were referred to treatment for LS, primarily bowel dysfunction. Among patients with rectal cancer, 30.8% requested phone contact and 16.2% were referred for treatment of LS, mainly due to bowel and sexual dysfunction. Conclusion: This is the first paper investigating a new method of systematic screening for LS following colorectal cancer using electronic patient‐reported outcome measures. The study shows that in the Danish population a high response rate can be obtained with this method and that close to three‐quarters of patients respond electronically. Patients with rectal cancer had a higher need for phone contact and treatment of LS than patients with colon cancer. [ABSTRACT FROM AUTHOR]