Female CRC Survivors May Experience Long-Term GI Symptoms

Patricia McKnight

August 09, 2023


Most older women who are colorectal cancer (CRC) survivors experience prolonged gastrointestinal (GI) symptoms many years after diagnosis and treatment, suggesting a need to improve GI symptom management in this population.


  • In this cross-sectional study, investigators used data from the Women's Health Initiative (WHI) Life and Longevity After Cancer study to explore the impact of cancer treatments on persistent GI symptoms in long-term female CRC survivors and why some patients suffer from these symptoms.

  • The cohort consisted of 413 postmenopausal women aged 50 to 79 years. The mean age of the patients was 62.7 years at the time of CRC diagnosis and 71.2 years at survey completion.

  • Study participants received a CRC diagnosis, mostly in the colon (n = 341), before 2011.

  • Participants completed lifestyle questionnaires at baseline and annually thereafter. The questionnaires assessed a range of factors, including GI symptoms, psychological well-being, physical activity, and dietary habits.


  • Most CRC survivors (81%) reported persistent GI symptoms more than 8 years after their cancer diagnosis.

  • Abdominal bloating/gas was the most common symptom (54.2%), followed by constipation (44.1%), diarrhea (33.4%), and abdominal/pelvic pain (28.6%). Overall, 15.4% of CRC survivors reported having moderate to severe overall GI symptoms.

  • Psychological distress — namely, fatigue, sleep disturbance, and anxiety — represented the most important risk factor for long-term GI symptoms. Other risk factors included time since cancer diagnosis of less than 5 years, advanced cancer stage, poor dietary habits, and low physical activity.

  • GI symptoms affected survivors' quality of life, functioning, and body image.


"Building upon prior work, our findings contribute to the literature by demonstrating strong relationships between GI symptoms and psychological symptoms," the authors concluded. "Our findings shed light on the importance of psychosocial support as well as lifestyle interventions (specifically nutritional management) in managing GI symptoms in CRC survivors."


  • The study was led by Claire Han and was published in PLOS ONE in May 2023.


  • The cross-sectional study design limited the researchers' ability to identify causal effects with respect to risk factors, life impact, and GI symptoms.

  • Symptom data were self-reported, so may have been underreported or overreported.


  • The study had no direct funding support. The original data collection for the WHI was funded by the National Heart, Lung, and Blood Institute.

  • Authors have disclosed no relevant financial relationships.

For more from Medscape Oncology, join us on Twitter and Facebook.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.