Abstract
PURPOSE: Little is known about how colorectal (CRC) survivors and their partners communicate about cancer or experience fear of cancer recurrence (FCR). To effectively support and guide survivors and partners, we designed a dyadic survey and investigated whether survivors' health-related quality of life (HRQoL) was associated with dyadic discordance in communication or FCR. METHODS: From 2019-2020 we surveyed survivors of stage III CRC and their partners. We measured dyadic cancer communication using the Lewis Mutuality and Interpersonal Sensitivity Scale. We asked dyads 3 questions about FCR. We measured survivors' HrQoL using the PROMIS-29 + 2 profile, v 2.1. We used bivariate analyses and multivariable logistic regressions to compare survivor and partner responses, describe characteristics of discordant dyads, and assess associations between survivors' HrQoL and discordance in cancer communication and FCR. RESULTS: We analyzed data from 307 paired survivor-partner dyads (51% survivor response rate; 73% partner response rate). 29% dyads were discordant in cancer communication. 26% dyads were discordant in FCR. Greater discordance in cancer communication was associated with female survivor sex and greater partner educational attainment. Greater discordance in FCR was associated with younger survivor age and receipt of radiation (all p < 0.05). Worse survivor HRQoL was associated with greater discordance in FCR and receipt of radiation (all p < 0.01). CONCLUSIONS: Our findings highlight the complex dynamics dyads experience during CRC survivorship. While open communication is crucial, differing levels of shared fears and concerns can significantly impact health-related quality of life (HRQoL). Addressing these issues, especially FCR, can enhance patient-centered survivorship care.