P502 - Qualitative Experiences of Financial Toxicity and Professional Impact of Early Onset Colorectal Cancer

Purpose/Background: Colorectal cancer (CRC) and its treatment place substantial financial burdens on patients, with younger patients known to be disproportionately affected given earlier career stages and lower financial security. Despite growing quantitative evidence, the lived financial and professional impacts of CRC among younger adults remain underexplored. To identify targets for potential intervention, we conducted a qualitative study among patients with early-onset CRC.

Methods/Interventions: We aimed to explore the financial and professional impacts of CRC among younger adults (those less than 50 years) during and after treatment. We used convenience sampling to recruit 63 patients who underwent surgery across seven academic medical centers. The sample was evenly distributed between males (n=32, 51%) and females (n=31, 49%). Age at diagnosis ranged from 18 to 49 years, with a mean age of 40 years. Most participants identified as white (n=39, 62%). Of the participants, 51% (n=32) had colon cancer and 49% (n=31) had rectal cancer. Data were analyzed using a systematic and iterative approach guided by both directed and conventional content analysis.

Results/Outcomes: Data revealed a range of experiences related to professional and financial impacts, from none to severe. For those affected financially, expenses such as treatment costs, indirect costs, income loss, job loss, reduced assets, and debt were noted (Figure 1). Those experiencing professional impacts, cited physical and cognitive limitations, psychological challenges, and career disruptions (Table 1). Although participants faced similar struggles across the spectrum, certain protective factors such as supportive work environments, greater insurance coverage, higher salaries, and strong support networks were frequently seen as buffers against more severe impacts.

Conclusion/Discussion: Younger adults with CRC experience substantial financial and professional disruptions, with hourly wage earners and those lacking robust insurance disproportionately affected. While supportive employers, comprehensive insurance coverage, higher salaries, and strong social networks mitigated harms, these protections were unevenly distributed. As the population of early-onset CRC patients and survivors expands, programs that pair financial navigation with work-accommodation support (e.g., leave planning, phased return/flexible scheduling) may reduce financial stressors.

Financial Impacts of Early Onset Colon Cancer
Professional Impacts of Early Onset Colon Cancer