Supportive Care Needs of Individuals With Colorectal Cancer in a Low- and Middle-Income Setting: Implications for Advancing Patient-Centered Cancer Care.

BACKGROUND

Increasing prevalence of colorectal cancer (CRC) demands comprehensive understanding of the corresponding supportive care needs (SCN), especially in low and middle-income settings.

AIMS

We measured SCN following CRC in a multiethnic, upper middle-income setting, and the associated factors.

METHODS

Six-hundred-thirty individuals with CRC were recruited from seven oncology centres and a non-governmental organization in Malaysia. A locally developed, and validated 48-item bilingual Needs Assessment Tool for Colorectal Cancer with a 6-point Likert scale was used to assess six domains: diagnosis, psychosocial and information, healthcare, practical, financial, and employment. Vulnerable subgroups were identified using multivariable generalized linear models.

RESULTS

High healthcare needs (78.6%) namely shorter hospital waiting times (79.7%) and conveniently located hospital facilities (79.5%), as well as, psychosocial and information needs (70.0%) including easily understood information (87.9%) and compassion from healthcare teams (73.0%) were highly prevalent. High diagnosis (59.4%), financial (36.8%), employment (31.7%), and practical needs (26.7%) also prevailed. Multivariable analyses identified several vulnerable subgroups with high SCN across multiple domains: Younger age (< 60 years) was significantly associated with heightened SCN, especially in psychosocial and information, financial, employment and practical domains. Receiving care in public hospitals was significantly associated with increased psychosocial and information needs, and healthcare needs. Those living with CRC over longer terms (> 3 years vs. 1 year) reported higher practical needs.

CONCLUSION

As the SCN of patients with CRC extend beyond the traditional scope of disease-directed oncology care, addressing high levels of needs in resource-limited settings will require collective action across diverse disciplines and sectors.