Financial and Occupational Impact of Low Anterior Resection Syndrome in Rectal Cancer Survivors.

AIM The objective of this study was to assess bowel-related financial stress and strain and to evaluate its association with global quality of life. METHOD This was a retrospective cohort study with cross-sectional follow-up including consecutive patients who underwent restorative proctectomy for neoplastic disease of the rectum at a single university-affiliated hospital in Montreal, Quebec, Canada. Bowel-related financial impact and occupational impact was compared between patients with major Low Anterior Resection Syndrome (LARS) and those with minor/no LARS. The association between LARS, bowel-related financial impact, and global quality of life was then assessed in a multiple logistic regression model. RESULTS Of 180 eligible rectal cancer survivors who were contacted, 154 completed the questionnaires (response rate: 47.1%) at a median follow-up of 57.5 months (IQR: 34.1-98.1) after proctectomy. Individuals with major LARS reported a higher prevalence of bowel-related financial stress (53.2% vs. 5.6%, p<0.001) and strain (42.2% vs. 5.6%, p<0.001) compared to those with minor/no LARS. Among those who were working preoperatively (n=100), the majority of participants with major LARS reported an impact of their new bowel function on ability to work (70.6%), including delayed return to work (44.1%), the need to change schedules (35.3%) or roles (20.6%), and complete long-term medical absence from work (14.7%). On multiple logistic regression, major LARS with financial impact (OR: 4.50, 95% CI 1.57-13.77) was associated with low global QoL compared to minor/no LARS. CONCLUSION Major LARS was associated with considerable financial stress and strain and difficulties returning to work.