Prospective evaluation of bowel function and quality of life after colon cancer surgery - is it time for routine screening for late sequelae?

Annette Boesen Bräuner, Nicolas Avellaneda, Peter Christensen, Asbjørn Mohr Drewes, Katrine Jøssing Emmertsen, Klaus Krogh, Søren Laurberg, Michael Bødker Lauritzen, Uffe Schou Løve, Ole Thorlacius-Ussing, Therese Juul*

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review


Aim: Bowel dysfunction after colon cancer (CC) surgery is widely neglected in current follow up programmes. This study explored changes in bowel function and quality of life (QoL) from three (3 m) to twelve months (12 m) after surgery in CC patients undergoing right- or left-sided colon resection (RightSCR/LeftSCR) and investigated differences between the two groups 12 m after surgery. Method: CC patients undergoing surgical resection in 2018–2020 at five surgical departments were included in this population-based prospective cohort study. Included patients completed electronic surveys consisting of a collection of validated scores 3 m and 12 m after surgery. Results: A total of 708 CC patients (423 RightSCR, 285 LeftSCR) were included. In RightSCR, no improvement was observed from 3 m to 12 m in most scores/items, on the contrary, symptom worsening in flatus- and faecal incontinence and urgency was observed (p < 0.05). Also, the proportion of patients rating their bowel function as very good/good decreased (p < 0.05) in this group. In LeftSCR improvement was found in flatus and faecal incontinence, urgency and night-time defaecation (p < 0.02), while no improvement was observed in the remaining scores/items. At 12 m, higher proportions of RightSCR than LeftSCR reported loose stools, incontinence and urgency (all p < 0.001), whereas LeftSCR more often reported hard stools and flatus incontinence (p < 0.05). Among all CC patients 18.3% reported bowel-related impairment of QoL at 12 m with no differences between the two groups. Conclusion: From 3 m to 12 m no significant change was observed in the majority of bowel function and QoL scores/items, however, some symptoms worsened in RightSCR, while a few improved in LeftSCR. Bowel dysfunction and impaired QoL were still common in both groups at 12 m, although the symptom pattern differed between the groups. These findings call for a systematic screening for bowel dysfunction to ensure early treatment of symptoms.

Original languageEnglish
JournalActa Oncologica
Pages (from-to)1132-1142
Number of pages11
Publication statusPublished - Sept 2023


  • Colonic Neoplasms/surgery
  • Defecation
  • Early Detection of Cancer
  • Fecal Incontinence/etiology
  • Flatulence
  • Gastrointestinal Diseases
  • Humans
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires


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