Sociodemographic and clinical factors associated with health-related quality of life among patients with colorectal cancer: a multicentre cross-sectional study in Italy

Background Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. The disease and its treatments significantly impact patients' quality of life (QoL), including physical, psychological, and social functioning. Patient-Reported Outcome Measures (PROMs) complement clinical assessments. This study aimed to evaluate factors influencing QoL among patients across type of treatments using the EORTC-C30 and QLQ-CR29 questionnaires. Methods This multicentre, cross-sectional observational study was conducted in seven Italian oncology centres from July 2022 to April 2023. A convenience sample of 498 adult patients was recruited from surgical, chemotherapy, and radiotherapy pathways. Multivariable linear regression with robust standard errors was used for multi-item scores, and ordinal logistic regression for single-item outcomes. Analyses used multiple imputation with outcome-specific exclusion of originally missing responses, complete-case sensitivity analyses, and false discovery rate (FDR) correction for secondary associations. Results Global Health Status/QoL was available for 486 patients (mean 65.79, SD 20.63). Lower scores were associated with poorer ECOG performance status ( β per point = −7.26; 95% CI −10.26 to −4.26), stoma presence ( β = −8.42; 95% CI −13.82 to −3.03), and insufficient income ( β = −6.58; 95% CI −11.33 to −1.82). After FDR correction, secondary findings included associations of poorer performance status with impaired functioning and greater symptom burden, insufficient income with financial difficulties, and stoma presence with sore skin and embarrassment. Conclusion Sociodemographic and clinical factors were associated with global health status/QoL and specific secondary outcomes. The findings highlight the relevance of personalised care addressing symptom management and social needs. Future research should focus on tailored interventions for the most vulnerable patient groups.