Differences in quality of life between early onset colorectal cancer patients compared to older patients: a qualitative study.

PURPOSE: Colorectal (bowel) cancer and its treatment can seriously affect a person's quality of life, including physical, social, work‑related, and emotional wellbeing. Young people with colorectal cancer experience worse psychological wellbeing, including marked emotional distress and prominent levels of anxiety. This disease is less common in people under 50, but cases of early‑onset colorectal cancer (EOCRC) are rising around the world. The object of this research was to derive a deeper understanding of the challenges and impact on quality of life faced by EOCRC compared to older patients following a colorectal cancer diagnosis.

METHOD: Recruitment of participants from a larger mixed method project of surviving EOCRC patients from 2013 to 2023 and a matched sample of colorectal cancer patients. 1 Participants invited to take part in an in‑depth semi-structured interview conducted by telephone or virtual meeting and audio taped, transcribed, and analysed using an interpretive phenomenological approach.

RESULTS

Twenty participants participated in interviews. Three themes (Headspace, physical impact and future) and eight corresponding sub themes encompassing poorer psychological quality of life, emotional distress and heightened anxiety faced by EOCRC. Barriers in current diagnostic services and treatment pathways more often reported by EOCRC.

CONCLUSION

Older and younger cancer patients highlight a shift from active to passive social roles with both groups reporting substantial reductions in overall quality of life and role functioning, but longer lasting impact for EOCRC, who are focused on family, fertility, career, and survival. A review of current diagnostic services and treatment pathways is required, tailoring care for all patients and importantly address the unique needs of EOCRC.