Age-related experiences of colorectal cancer diagnosis: a secondary analysis of the English National Cancer Patient Experience Survey

Abstract

ObjectiveThe incidence of colorectal cancer (CRC) in people aged <50 years has been increasing dramatically in the past three decades and such patients are known to face difficulties in diagnosis. The objective of this study was to better understand the diagnostic experiences of patients with CRC and explore age-related differences in the proportion with positive experiences.MethodA secondary analysis of the English National Cancer Patient Experience Survey (CPES) 2017 was conducted on the responses of patients with CRC, restricted to those likely to have been diagnosed in the preceding 12 months via pathways other than routine screening. Ten diagnosis-related experience questions were identified, with responses to them categorised as positive, negative or uninformative. Age group-related difference in positive experiences were described and ORs estimated, both raw and adjusted for selected characteristics. Sensitivity analysis was performed by weighting survey responses to 2017 cancer registrations by strata defined by age group, sex and cancer site, to assess whether differential response patterns by these characteristics affected the estimated proportion of positive experiences.ResultsThe reported experiences of 3889 patients with CRC were analysed. There was a significant linear trend (p<0.0001) for 9 of 10 experience items, with older patients consistently displaying higher rates of positive experiences and patients aged 55–64 showing rates of positive experience intermediate between younger and older age groups. This was unaffected by differences in patient characteristics or CPES response rates.ConclusionThe highest rates of positive diagnosis-related experiences were reported by patients aged 65–74 or 75 years and older, and this is robust.

‘Only to reconcile with it’. The coping experience amongst middle‐aged and older cancer survivors: A qualitative study

“…As in other studies, older cancer survivors are more likely to accept cancer and, as a result, report lower anxiety, depression, and suicide than younger adult cancer survivors 22,23 . Different from younger adults who have more negative beliefs about cancer, middle‐aged and older adults have an awareness that cancer is an ongoing chronic condition 24,25 . For this age group, fear may be temporary; moving towards a state of living with cancer as a chronic illness leads to adaption, reduction of fear, overcoming illness and planning for the future 26,27 .…”

“…22,23 Different from younger adults who have more negative beliefs about cancer, middle-aged and older adults have an awareness that cancer is an ongoing chronic condition. 24,25 For this age group, fear may be temporary; moving towards a state of living with cancer as a chronic illness leads to adaption, reduction of fear, overcoming illness and planning for the future. 26,27 Furthermore, under the influence of traditional philosophies and religious beliefs, including 'zhong sheng an si', 'spiritual immorality and the afterlife', 'life and death unified', 'fate' and 'cause and effect', our participants attributed cancer to fate or karma, considering this approach important for improving physiological and psychological well-being.…”

Understanding Colorectal Cancer Patient Experiences with Family Practitioners in Canada

“…Further, based on milestone markers highlighted in the survey, on average, participants experienced their CRC diagnostic process during their early 40s and the process took 1–2 years from symptom onset. Similarly, studies have found that younger age groups face more difficult diagnostic paths and less positive diagnosis-related care experiences than do older age groups [ 31 , 32 , 33 ]. The observed trends concerning EAO cancers suggest a need to encourage symptom awareness, screening, and seeking of medical aid amongst younger individuals to improve upon earlier detection [ 25 ].…”

Dietary intake data for patients with and without colorectal cancer: A logistic lasso regression analysis

“…Among the three levels of tumor prevention, the most important one is primary prevention, which reduces the incidence of the disease by reducing the associated risk factors. As a result, research into the causative factors of colorectal cancer remains ongoing, with age, gender, and race recognized as contributing factors to its incidence [4,5]. As an external risk factor, diet is a crucial factor in the development of colorectal cancer as it affects the intestinal microenvironment [6].…”