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早发性结直肠癌的临床挑战与患者体验:来自七个欧洲国家的见解

Clinical challenges and patient experiences in early-onset colorectal cancer: insights from seven European countries.

作者信息

Vitaloni Marianna, Maguet Katell, Carlan Andi, Stack Patricia, de Jong Vincent, Williams Ross, Maravic Zorana

机构信息

Digestive Cancers Europe, Brussels, Belgium.

Bowel Cancer Ireland, Dublin, Ireland.

出版信息

BMC Gastroenterol. 2025 May 15;25(1):378. doi: 10.1186/s12876-025-03976-y.

Abstract

BACKGROUND

The incidence of early-onset colorectal cancer (eoCRC), defined as CRC diagnosed in individuals under 50, is rising globally. Younger patients often face diagnostic delays and receive care pathways designed for older populations. These gaps highlight the need for tailored approaches to diagnosis, treatment, and support.

OBJECTIVE

This study aimed to explore the lived experiences and challenges of eoCRC patients across seven European countries to inform public health strategies and improve patient-centered care.

METHODS

We conducted qualitative focus groups with 47 eoCRC patients and survivors from France, Ireland, Italy, the Netherlands, Romania, Spain, and the United Kingdom. Discussions were analyzed using a thematic approach, focusing on three stages of the patient journey: pre-diagnosis, diagnosis, and post-diagnosis.

RESULTS

Participants highlighted several key challenges, including low awareness of CRC symptoms among younger populations, diagnostic delays linked to age and gender biases, and limited access to age-appropriate support services. Many participants reported significant quality-of-life (QoL) impacts related to disrupted careers, intimacy issues, and challenges managing family responsibilities during treatment. Psychological support, physiotherapy, and nutritional counseling were inconsistently available, with significant disparities across public and private healthcare systems.

CONCLUSIONS

The findings underscore the urgent need for targeted public health campaigns to raise awareness of eoCRC, improved training for healthcare providers to reduce diagnostic delays, and expanded access to tailored support services. Addressing these gaps is critical to mitigating the growing burden of eoCRC and improving outcomes for younger patients.

摘要

背景

早发性结直肠癌(eoCRC)定义为在50岁以下个体中诊断出的结直肠癌,其发病率在全球范围内呈上升趋势。年轻患者常常面临诊断延误,并接受为老年人群设计的护理路径。这些差距凸显了针对诊断、治疗和支持采取量身定制方法的必要性。

目的

本研究旨在探索七个欧洲国家eoCRC患者的生活经历和挑战,以为公共卫生策略提供信息并改善以患者为中心的护理。

方法

我们对来自法国、爱尔兰、意大利、荷兰、罗马尼亚、西班牙和英国的47名eoCRC患者及幸存者进行了定性焦点小组访谈。使用主题分析法对讨论内容进行分析,重点关注患者就医过程的三个阶段:诊断前、诊断和诊断后。

结果

参与者强调了几个关键挑战,包括年轻人群对结直肠癌症状的认识不足、与年龄和性别偏见相关的诊断延误,以及获得适合年龄的支持服务的机会有限。许多参与者报告称,治疗期间职业中断、亲密关系问题以及处理家庭责任方面的挑战对生活质量(QoL)产生了重大影响。心理支持、物理治疗和营养咨询的提供情况不一致,公共和私立医疗系统之间存在显著差异。

结论

研究结果强调迫切需要开展有针对性的公共卫生运动,以提高对eoCRC的认识,加强对医疗服务提供者的培训以减少诊断延误,并扩大获得量身定制的支持服务的机会。解决这些差距对于减轻eoCRC日益增长的负担以及改善年轻患者的治疗结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03ad/12083133/3862104bef45/12876_2025_3976_Fig1_HTML.jpg

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