Background: Colorectal cancer surgery improves outcomes but often leads to long-term physical and psychosocial challenges for patients and families. Limited evidence exists on the relationship between postoperative quality of life (QoL) and spousal caregiver burden, especially in non-Western settings. This study aimed to assess the QoL of colorectal cancer patients post-surgery and examine its association with the psychological burden experienced by their spouses.

Methods: This descriptive cross-sectional study recruited 99 colorectal cancer patients and their spouses from two hospitals in northern Iran in 2023. Patients’ QoL was measured using the WHO Disability Assessment Schedule II (WHODAS II), and caregiver burden was assessed using the Zarit Burden Interview (ZBI). Adults with confirmed colorectal cancer living with a caregiving spouse were included; those with severe cognitive impairment or incomplete data were excluded. Associations were analyzed using Pearson correlation and Chi-square tests.

Results: The patients’ mean age was 61.84 ± 12.10 years, while spouses averaged 51.14 ± 13.12 years. The majority underwent anterior resection (55.6%) or low anterior resection (30.3%). Patients reported moderate disability (mean WHODAS II score 22.20), particularly in social participation. The average caregiver burden was 6.98. Significant correlations existed between social participation difficulties and caregiver burden (r=0.308, p=0.002) and communication difficulties (r=0.202, p=0.045).

Conclusion: Postoperative QoL among colorectal cancer patients was suboptimal, with lower QoL associated with higher caregiver burden. These findings underscore the need for family-centered care and support strategies for caregivers.