QS221 - The Impact of Colorectal Cancer Diagnosis On Quality of Life Is Increased in Young Patients

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Purpose/Background: Early-onset colorectal cancer (EOCRC), is defined as colorectal cancer (CRC) diagnosed before the age of 50, and is increasing in incidence across the world, particularly in Australia and New Zealand. This study aims to assess Quality of Life (QoL) in young colorectal patients (EOCRC), comparing it to that in older patients with colorectal cancer. (OCRC). The study also aimed to address concerns about any distinct challenges and impacts on QoL that may be faced by younger individuals

Methods/Interventions: A mixed-methods approach was employed for this study. An initial survey using three validated instruments: the WHOQOL-BRIEF for general QoL, the QOL-CR30 tailored for all cancer patients, and the QOL-CR29, specifically designed for colorectal cancer patients. All surviving EOCRC patients diagnosed at the Northern Adelaide Local Health Network (NALHN) between January 2013 and December 2023 were invited to participate, and a matched sample of CRC patients diagnosed at age 50 or older, were also recruited to facilitate a comparative analysis. The second phase of the study involved qualitative interviews to explore the impact of CRC on QoL.

Results/Outcomes: Out of 244 invitation letters sent, 93 surveys were completed (38.1%), with 53.8% of respondents being female. The mean age of patients completing the survey was 46 for the EOCRC cohort and 72 for the OCRC cohort. Most patients had been diagnosed with CRC more than two years (88.9% in the OCRC cohort and 82.4% in the EOCRC cohort), prior to survey completion and the participants spanned all stages of cancer diagnosis.
Within the four domains of the WHOQOL-BRIEF tool, EOCRC patients exhibited significantly lower scores in psychological aspects (52.3±20.5) compared to the OCRC cohort (66.4±15.8), with a p-value of 0.0009. QoL scores fluctuated throughout the cancer journey, being lowest within the first-year post-diagnosis, peaking in the second year, and declining thereafter from the third year onward for EOCRC patients.
EOCRC patients reported more severe emotional problems (34.6 vs. 60.8, p = 0.0002 - QLQ-CR30), greater embarrassment about their condition (44.7 vs. 27.4, p = 0.04), higher levels of anxiety (22.0 vs. 49.2, p = 0.00007), and more concerns about weight (35.2 vs. 51.7, p = 0.04) and body image (41.7 vs. 65.6, p = 0.001-QLQ-CR29) compared to their older counterparts.
Qualitative findings revealed three overarching themes encompassing psychological distress/ headspace, physical aspects, and future. EOCRC patients described significant uncertainty for their future.

Conclusion/Discussion: The study demonstrates that patients with EOCRC face significant challenges including poor psychological wellbeing and severe emotional challenges compared to OCRC patients, emphasizing the need for tailored psychological support and intervention programs specifically designed for EOCRC across the trajectory to address their unique challenges