Quality of life assessment in patients with a stoma due to rectal cancer in Morocco

Colorectal cancer is a major public health problem in Morocco, according to the Moroccan. Cancer Registry; it represents the first gastro-intestinal cancer and the third most common cancer in Morocco. The aim of this paper is to compare the quality of life of rectal cancer patients with and without permanent colostomy in the course of rectal cancer treatment. Methods: Patients were recruited from the National Institute of Oncology in Rabat – Morocco, during the February 2016 - June 2018 period. The version of the third QLQ-C30 and C29 questionnaire of the European Organization for Research and Treatment of Cancer (EORTC) was translated for the first time in Moroccan Arabic and used to obtained relevant data. Psychometric properties were measured on patients with colorectal cancer recruited from different regions of the country. Statistical analysis included Cronbach's alpha, correlation, multi-trait scaling and known groups comparisons. p value ≤ 0.05 was considered significant. Results: In total, 102 patients with rectal cancer were included in the study and 45 (44 %) patients with stoma. The mean age at diagnosis time was 51 years (+/- 11.4). Stoma patients did not show significant impairment of functioning, which did not negatively influence their quality of life. Patients with stoma had higher symptom scores related to diarrhea and experienced more financial difficulty as measured by EORTC C-30, in clinically distinct group comparison. With EORTC C-29, this group showed lower Functional scales scores for body image, sexual dysfunction for female patients and higher symptom scores related to urinary frequency, troubles with taste, hair loss, sore skin, psychosocial disturbance in the form of embarrassment due to the frequent need to change the stoma bag compared to patients without a stoma. Conclusions: The experience of stoma has a not large negative impact on Moroccan patients' quality of life. Influence of stoma is most pronounced in the area of symptom and financial difficulty. Financial difficulties are, by far, more present.