Treatment edit
Psychosocial Intervention edit
In addition to medical intervention, a variety of psychosocial interventions have been implemented in the treatment of colorectal cancer.[1] Depression and anxiety are highly prevalent in patients diagnosed with CRC, therefore psychosocial interventions are necessary.[2][3] Many patients continue to experience symptoms of anxiety and depression following treatment, regardless of treatment outcome.[2][4] Societal stigmas associated with colorectal cancer present further psychosocial challenges for CRC patients and their families.[5][6]
Depression and Anxiety edit
Colorectal cancer patients have a 51% higher risk of experiencing depression than individuals without the disease.[3] Additionally, CRC patients are at high risk of experiencing severe anxiety, low self-esteem, poor self-concept, and social anxiety.[2][7]
Post-Treatment Distress edit
Regardless of treatment outcome, many CRC patients experience ongoing symptoms of anxiety, depression, and distress.[2]
Survivorship of CRC can involve significant lifestyle adjustments.[6] Postoperative afflictions may include stomas, bowel issues, incontinence, odor, and changes to sexual functioning.[6][7] These changes can result in distorted body image, social anxiety, depression, and distress—all of which contribute to a poorer quality of life.[6][8]
Colorectal cancer is the second leading cause of cancer-related death worldwide.[9] Transitioning into palliative care and contending with mortality can be a deeply distressing experience for a CRC patient and their loved ones.
Stigma edit
Colorectal cancer is highly stigmatized and can elicit feelings of disgust from patients, healthcare professionals, family, intimate partners, and the general public.[5] Patients with stomas are especially vulnerable to stigmatization due to unavoidable odors, gas, and unpleasant noises from stoma bags.[5] Additonally, associated CRC risk factors like poor diet, alcohol consumption, and lack of physical activity prompt negative assumptions of blame and personal responsibility onto CRC patients.[6] Judgement from others along with internalized self-blame and embarrassment can negatively affect self-esteem, sociability, and quality of life.[6]
Methods of Intervention edit
Face-to-face interventions such as clinician-patient talk therapy, body-mind-spirit practices, and support group sessions have been identified as most effective in reducing anxiety and depression in CRC patients.[1] Additionally, journaling exercises and over-the-phone talk therapy sessions have been implemented.[1] Though deemed less effective, these non-face-to-face interventions are economically inclusive and have been found to reduce both depression and anxiety in CRC patients.[1]
Early Onset Colorectal Cancer (EOCC) edit
A diagnosis of colorectal cancer in patients under 50 years of age is referred to as Early Onset Colorectal Cancer (EOCC).[9][10]Instances of EOCC have increased over the last decade, specifically in patient populations aged 20-40 years old throughout North America, Europe, Australia, and China.[10][11]
Incidence by Age edit
Incidences of colorectal cancer in younger populations have increased over the last decade.[9][10][11]While advancements in diagnostic procedure may have some impact, reduced likelihood of screening among these populations suggests detection bias is not a major contributor to this trend. More likely, cohort-effects are at play.[11]
The population experiencing the greatest rise in EOCC cases are men and women aged 20-29 years old, with incidences increasing by 7.9% a year between 2004 and 2016.[11] Similarly, though less severe, men and women aged 30-39 experienced an increase in cases at a rate of 3.4% a year during that same time period. Despite these increases, the mortality rate for colorectal cancer has remained the same.[11]
Risk Factors edit
Risk factors associated with EOCC are akin to those of all colorectal cancer cases.[10] Observed cohort-effects are likely the product of generational shifts in lifestyle and environmental factors.[9][10]
Preventative Screening edit
In 2018, the American Cancer Society modified their previous screening guideline for colorectal cancer from age 50 down to age 45 following the recognition of increasing cases of EOCC.[11] Individuals under the age of 60 have been identified as most susceptible to non-participation in colorectal cancer screening.[12]
- ^ a b c d Son, Heesook; Son, Youn-Jung; Kim, Hyerang; Lee, Yoonju (2018-06-08). "Effect of psychosocial interventions on the quality of life of patients with colorectal cancer: a systematic review and meta-analysis". Health and Quality of Life Outcomes. 16 (1): 119. doi:10.1186/s12955-018-0943-6. ISSN 1477-7525. PMC 5994008. PMID 29884182.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ a b c d Peng, Yu-Ning; Huang, Mei-Li; Kao, Chia-Hung (2019-01-31). "Prevalence of Depression and Anxiety in Colorectal Cancer Patients: A Literature Review". International Journal of Environmental Research and Public Health. 16 (3): 411. doi:10.3390/ijerph16030411. ISSN 1660-4601. PMC 6388369. PMID 30709020.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ a b Cheng, Vicki; Oveisi, Niki; McTaggart-Cowan, Helen; Loree, Jonathan M.; Murphy, Rachel A.; De Vera, Mary A. (2022). "Colorectal Cancer and Onset of Anxiety and Depression: A Systematic Review and Meta-Analysis". Current Oncology. 29 (11): 8751–8766. doi:10.3390/curroncol29110689. ISSN 1718-7729. PMC 9689519. PMID 36421342.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ Mosher, Catherine E.; Winger, Joseph G.; Given, Barbara A.; Helft, Paul R.; O'Neil, Bert H. (2016). "Mental health outcomes during colorectal cancer survivorship: a review of the literature: Mental health in colorectal cancer survivorship". Psycho-Oncology. 25 (11): 1261–1270. doi:10.1002/pon.3954. PMC 4894828. PMID 26315692.
{{cite journal}}: CS1 maint: PMC format (link) - ^ a b c Reynolds, Lisa M.; Consedine, Nathan S.; Pizarro, David A.; Bissett, Ian P. (2013). "Disgust and Behavioral Avoidance in Colorectal Cancer Screening and Treatment: A Systematic Review and Research Agenda". Cancer Nursing. 36 (2): 122–130. doi:10.1097/NCC.0b013e31826a4b1b. ISSN 0162-220X.
- ^ a b c d e f Phelan, Sean M.; Griffin, Joan M.; Jackson, George L.; Zafar, S. Yousuf; Hellerstedt, Wendy; Stahre, Mandy; Nelson, David; Zullig, Leah L.; Burgess, Diana J.; van Ryn, Michelle (2013). "Stigma, perceived blame, self‐blame, and depressive symptoms in men with colorectal cancer". Psycho-Oncology. 22 (1): 65–73. doi:10.1002/pon.2048. ISSN 1057-9249. PMC 6000725. PMID 21954081.
{{cite journal}}: CS1 maint: PMC format (link) - ^ a b Hoon, Lim Siew; Chi Sally, Chan Wai; Hong-Gu, He (2013). "Effect of psychosocial interventions on outcomes of patients with colorectal cancer: A review of the literature". European Journal of Oncology Nursing. 17 (6): 883–891. doi:10.1016/j.ejon.2013.05.001. ISSN 1462-3889.
- ^ Meng, Xinyu; Wang, Xiaodong; Dong, Zaiquan (2021-10-01). "Impact of non-pharmacological interventions on quality of life, anxiety, and depression scores in patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials". Supportive Care in Cancer. 29 (10): 5635–5652. doi:10.1007/s00520-021-06185-x. ISSN 1433-7339.
- ^ a b c d Hua, Hongmei; Jiang, Qiuping; Sun, Pan; Xu, Xing (2023-05-05). "Risk factors for early-onset colorectal cancer: systematic review and meta-analysis". Frontiers in Oncology. 13. doi:10.3389/fonc.2023.1132306. ISSN 2234-943X.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ a b c d e Puzzono, Marta; Mannucci, Alessandro; Grannò, Simone; Zuppardo, Raffaella Alessia; Galli, Andrea; Danese, Silvio; Cavestro, Giulia Martina (2021). "The Role of Diet and Lifestyle in Early-Onset Colorectal Cancer: A Systematic Review". Cancers. 13 (23): 5933. doi:10.3390/cancers13235933. ISSN 2072-6694. PMC 8657307. PMID 34885046.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) - ^ a b c d e f Vuik, Fanny ER; Nieuwenburg, Stella AV; Bardou, Marc; Lansdorp-Vogelaar, Iris; Dinis-Ribeiro, Mário; Bento, Maria J; Zadnik, Vesna; Pellisé, María; Esteban, Laura; Kaminski, Michal F; Suchanek, Stepan; Ngo, Ondřej; Májek, Ondřej; Leja, Marcis; Kuipers, Ernst J (2019). "Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years". Gut. 68 (10): 1820–1826. doi:10.1136/gutjnl-2018-317592. ISSN 0017-5749. PMC 6839794. PMID 31097539.
{{cite journal}}: CS1 maint: PMC format (link) - ^ Unanue-Arza, Saloa; Solís-Ibinagagoitia, Maite; Díaz-Seoane, Marta; Mosquera-Metcalfe, Isabel; Idigoras, Isabel; Bilbao, Isabel; Portillo, Isabel (2020-12-12). "Inequalities and risk factors related to non-participation in colorectal cancer screening programmes: a systematic review". The European Journal of Public Health. 31 (2): 346–355. doi:10.1093/eurpub/ckaa203. ISSN 1101-1262. PMC 8071594. PMID 33313657.