EP1070 - Qualitative Analysis of Unmet Communication Needs in Early Onset Colorectal Cancer Survivors

Purpose/Background: Over the past two decades, the incidence of colorectal cancer (CRC) among adults less than 50 years of age is increasing at an alarming rate (i.e., early-onset CRC). Prior work has demonstrated that poor communication between younger patients with cancer and healthcare providers may contribute to delayed evaluation and treatment. Despite this, few studies have specifically examined communication needs in this rapidly growing population of CRC survivors.

Methods/Interventions: Semi-structured qualitative interviews were conducted with patients diagnosed with early-onset CRC (n=63). Participants were recruited from seven academic medical institutions where they had received CRC treatment. Interview data were analyzed using a validated codebook and themes were abstracted in accordance with the five domains of patient-centered communication outlined in Gorman et al (Patient Educ Couns, 2018).

Results/Outcomes: The average participant age was 40 years old (M=40, IQR=37-45). 78% of participants identified as white and 49% (n=31) female. Of this cohort, 51% (n=32) of participants had colon cancer, 49% (n=31) had rectal cancer. Participants shared a variety of unmet needs relating to provider-patient communication, some of which were unique to the young adult cancer experience. Domains and exemplary quotes are displayed in Table 1:

1) Communication during follow-up care in a clinical setting: Patients desired more communication from providers about what to expect during care, especially after completion of treatment.

2) Patient engagement through expressive communication: Patients desired more in-person or direct communication with providers as opposed to portal messaging.

3) Communication training for health care professionals: Patients requested for provider communication to be individually tailored and to discuss topics relevant to younger patients such as sex, exercise, and nutrition.

4) Print and/or electronic media tools: Patients expressed a need for media explaining the role of different specialists and detailing common treatment side effects and how to address them.

5) Peer survivor gatherings for information-sharing: Patients shared that in addition to communicating with providers, they would have liked to connect with other survivors for health-related advice and resources. There is a particular need for more organized gatherings for young survivors.

Conclusion/Discussion: Participants shared critical feedback related to the format, content, structure, and delivery of patient-provider communication, which could improve their care experience. These needs could be addressed through a) open, in-person communication with providers; b) the development of standardized informational materials including content specific to the needs of younger patients with CRC; and c) the establishment of peer support networks for younger cancer survivors. Future efforts should focus on the development and validation of materials and training that target these areas.

Thematic Domains and Exemplary Quotes