"Too young to have this kind of diagnosis": A qualitative exploration of younger adults' experiences of colorectal cancer diagnosis.

Autor: Bergin RJ; Cancer Epidemiology Division, Cancer Council Victoria, East Melbourne, Victoria, Australia.; Department of General Practice and Primary Care, Centre for Cancer Research, University of Melbourne, Melbourne, Victoria, Australia., Ashley A; School of Psychology, Deakin University, Burwood, Victoria, Australia., Hardstaff J; School of Psychology, Deakin University, Burwood, Victoria, Australia., White V; School of Psychology, Deakin University, Burwood, Victoria, Australia.; Centre for Behavioural Research in Cancer, Cancer Council Victoria, East Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Psycho-oncology [Psychooncology] 2024 May; Vol. 33 (5), pp. e6344.
DOI: 10.1002/pon.6344
Abstrakt: Objective: Colorectal cancer (CRC) incidence is rising among adults under the age of 50 (early- or young-onset CRC). This population is more likely to have advanced-stage disease at diagnosis, suggesting their diagnostic pathway may be prolonged. To better understand factors influencing this pathway, this study explored patients' experiences of decision-making during a diagnosis of young-onset CRC.
Methods: Semi-structured interviews were conducted with 17 participants with young-onset CRC diagnosed in 2021-2022 in Victoria, Australia. Interviews were conducted online or by phone an average 7 months (range 1-13) after diagnosis. Analysis was approached from a critical realist perspective, with themes developed inductively using reflexive thematic analysis.
Results: Five themes were identified: Shifting Perception of Urgency, Multidimensional Perception of Role, Making the Most of Resources, Stage of Life, and COVID Adds Complexity. Participants' decision-making evolved over the diagnostic period. As participants perceived urgency to act, they took on a more active role in decision-making, utilising personal resources to access timely care. Their decisions were shaped by stage-of-life considerations, including employment and caring for a young family, with the COVID-19 pandemic adding "…a whole other layer of complexity" to the process.
Conclusions: Younger adults with CRC make decisions in the context of unique considerations, adapting to reduce time to diagnosis, with decisions complicated by the COVID-19 pandemic. Greater support from health care providers/systems in the diagnostic period may improve timeliness of CRC diagnosis and outcomes in younger adults.
(© 2024 The Authors. Psycho‐Oncology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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