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Unmet supportive care needs in colorectal cancer: differences by age

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Abstract

Purpose

Cancer is primarily a disease of ageing, yet the unmet supportive care needs of older cancer patients are not well understood. This study aims to explore how unmet needs differ by age over the 3 months following colorectal cancer surgery.

Methods

Control groups from pilot phases of an ongoing randomised trial completed the Supportive Care Needs Survey-Short Form 34 (SCNS-SF34) at 1 and 3 months following hospital discharge (n = 57). Multiple regression was used to investigate whether age was an independent predictor of unmet needs in each of the five SCNS-SF34 domains. The proportion of patients with unmet needs and the pattern of item responses were compared between patients aged <65 and ≥65 years at both time points.

Results

Older age independently predicted significantly lower levels of unmet need than younger age in nearly all SCNS-SF34 domains. However, more than half of all older patients had unmet needs at both time points (56% and 65%), and age differences in unmet needs were less apparent by 3 months. Older patients were less likely than younger patients to report ‘satisfied’ needs, as older patients were significantly more likely to report items were ‘not applicable’ at both 1 month (mean difference 29%, p < 0.001) and 3 months (mean difference 23%, p = 0.01).

Conclusions

While older patients reported lower levels of unmet need than younger patients, the high prevalence of unmet needs and age differences in item response patterns indicate that further research is needed to determine whether older patients' needs are being accurately captured.

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References

  1. Ahmed N, Ahmedzai S, Vora V, Hillam S, Paz S (2004) Supportive care for patients with gastrointestinal cancer. Cochrane Database Syst Rev 3:CD003445

    PubMed  Google Scholar 

  2. AIHW (Australian Institute of Health and Welfare) (2010) ACIM (Australian Cancer Incidence and Mortality) Books. http://www.aihw.gov.au/cancer/data/acim_books/index.cfm. Accessed 21 Feb 2011

  3. Amalraj S, Starkweather C, Nguyen C, Naeim A (2009) Health literacy, communication, and treatment decision-making in older cancer patients. Oncology 23:369–375

    PubMed  Google Scholar 

  4. Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Oakley C, Palmer N, Ream E, Young A, Richardson A (2009) Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol 27:6172–6179

    Article  PubMed  Google Scholar 

  5. Asadi-Lari M, Tamburini M, Gray D (2004) Patients' needs, satisfaction, and health related quality of life: towards a comprehensive model. Health Qual Life Outcome 2:32

    Article  Google Scholar 

  6. Barg FK, Cronholm PF, Straton JB, Keddem S, Knott K, Grater J, Houts P, Palmer SC (2007) Unmet psychosocial needs of Pennsylvanians with cancer: 1986–2005. Cancer 110:631–639

    Article  PubMed  Google Scholar 

  7. Boyes A, Girgis A, Lecathelinais C (2009) Brief assessment of adult cancer patients' perceived needs: development and validation of the 34-item supportive care needs survey (SCNS-SF34). J Eval Clin Pract 15:602–606

    Article  PubMed  Google Scholar 

  8. Brazier JE, Walters SJ, Nicholl JP, Kohler B (1996) Using the SF-36 and EuroQol on an elderly population. Qual Life Res 5:195–204

    Article  PubMed  CAS  Google Scholar 

  9. De Marco MF, Janssen-Heijnen ML, van der Heijden LH, Coebergh JW (2000) Comorbidity and colorectal cancer according to subsite and stage: a population-based study. Eur J Cancer 36:95–99

    Article  PubMed  Google Scholar 

  10. Devon K, Vergara-Fernandez O, Victor J, McLeod R (2009) Colorectal cancer surgery in elderly patients: presentation, treatment, and outcomes. Dis Colon Rectum 52:1272–1277

    Article  PubMed  CAS  Google Scholar 

  11. Extermann M, Aapro M, Bernabei R, Cohen HJ, Droz J-P, Lichtman S, Mor V, Monfardini S, Repetto L, Sorbye L, Topinkova E (2005) Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol 55:241–252

    Article  PubMed  Google Scholar 

  12. Fayers PM, Curran D, Machin D (1998) Incomplete quality of life data in randomized trials: missing items. Stat Med 17:679–696

    Article  PubMed  CAS  Google Scholar 

  13. Fitzsimmons D, Gilbert J, Howse F, Young T, Arrarras J-I, Brédart A, Hawker S, George S, Aapro M, Johnson CD (2009) A systematic review of the use and validation of health-related quality of life instruments in older cancer patients. Eur J Cancer 45:19–32

    Article  PubMed  Google Scholar 

  14. Girgis A, Boyes A, Sanson-Fisher RW, Burrows S (2000) Perceived needs of women diagnosed with breast cancer: rural versus urban location. Aust N Z J Public Health 24:166–173

    Article  PubMed  CAS  Google Scholar 

  15. Harrison JD, Young JM, Solomon MJ, Butow PN, Masya L (2011) Randomised pilot evaluation of the supportive care intervention “CONNECT” for people following surgery for colorectal cancer. Dis Colon Rectum 54:622–631

    Article  PubMed  Google Scholar 

  16. Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ (2009) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17:1117–1128

    Article  Google Scholar 

  17. Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley, New York

    Book  Google Scholar 

  18. Jansen J, van Weert J, van Dulmen S, Heeren T, Bensing J (2007) Patient education about treatment in cancer care: an overview of the literature on older patients' needs. Cancer Nurs 30:251–260

    Article  PubMed  Google Scholar 

  19. Johnson C, Fitzsimmons D, Gilbert J, Arrarras J-I, Hammerlid E, Bredart A, Ozmen M et al (2010) Development of the European Organisation for research and treatment of cancer quality of life questionnaire module for older people with cancer: the EORTC QLQ-ELD15. Eur J Cancer 46:2242–2252

    Article  PubMed  Google Scholar 

  20. King M, Colagiuri B, Butow P, Luckett T, Price M, Birney DP (2010) Health-related quality of life versus needs assessment: do conceptual distinctions translate empirically? Paper presented at the Sydney Cancer Conference, University of Sydney, Australia, 15–17 July

  21. Lansbury G (2000) Chronic pain management: a qualitative study of elderly people's preferred coping strategies and barriers to management. Disabil Rehabil 22:2–14

    Article  PubMed  CAS  Google Scholar 

  22. Lichtman SM (2009) Chemotherapy in the elderly: are their needs being met? Therapy 6:893–902

    Article  Google Scholar 

  23. McElduff P, Boyes A, Zucca A, Girgis A (2004) The supportive care needs survey: a guide to administration, scoring and analysis. Centre for Health Research and Psycho-Oncology, Newcastle

    Google Scholar 

  24. McPherson CJ, Wilson KG, Murray MA (2007) Feeling like a burden: exploring the perspectives of patients at the end of life. Soc Sci Med 64:417–427

    Article  PubMed  Google Scholar 

  25. Orimo H, Ito H, Suzuki T, Araki A, Hosoi T, Sawabe M (2006) Reviewing the definition of “elderly”. Geriatr Gerontol Int 6:149–158

    Article  Google Scholar 

  26. Pal SK, Katheria V, Hurria A (2010) Evaluating the older patient with cancer: understanding frailty and the geriatric assessment. CA Cancer J Clin 60:120–132

    Article  PubMed  Google Scholar 

  27. Sanoff HK, Bleiberg H, Goldberg RM (2007) Managing older patients with colorectal cancer. J Clin Oncol 25:1891–1897

    Article  PubMed  Google Scholar 

  28. Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Cancer 88:226–237

    Article  PubMed  CAS  Google Scholar 

  29. Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27:2758–2765

    Article  PubMed  Google Scholar 

  30. Smith DP, Supramaniam R, King MT, Ward J, Berry M, Armstrong BK (2007) Age, health, and education determine supportive care needs of men younger than 70 years with prostate cancer. J Clin Oncol 25:2560–2566

    Article  PubMed  Google Scholar 

  31. Soothill K, Morris SM, Harman J, Francis B, Thomas C, McIllmurray MB (2001) The significant unmet needs of cancer patients: probing psychosocial concerns. Support Care Cancer 9:597–605

    Article  PubMed  CAS  Google Scholar 

  32. Steginga SK, Occhipinti S, Dunn J, Gardiner RA, Heathcote P, Yaxley J (2001) The supportive care needs of men with prostate cancer. Psychooncology 10:66–75

    Article  PubMed  CAS  Google Scholar 

  33. Thewes B, Butow P, Girgis A, Pendlebury S (2004) The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors. Psychooncology 13:177–189

    Article  PubMed  CAS  Google Scholar 

  34. Victor C, Scambler S, Bond J, Bowling A (2000) Being alone in later life: loneliness social isolation and living alone. Rev Clin Gerontol 10:407–417

    Article  Google Scholar 

  35. Walters K, Iliffe S, Orrell M (2001) An exploration of help-seeking behaviour in older people with unmet needs. Fam Pract 18:277–282

    Article  PubMed  CAS  Google Scholar 

  36. Wright J, Williams R, Wilkinson JR (1998) Development and importance of health needs assessment. Br Med J 316:1310–1313

    Article  CAS  Google Scholar 

  37. Yong HH (2006) Can attitudes of stoicism and cautiousness explain observed age-related variation in levels of self-rated pain, mood disturbance and functional interference in chronic pain patients? Eur J Pain 10:399–407

    Article  PubMed  Google Scholar 

  38. Young J, Harrison J, Solomon M, Butow P, Dennis R, Robson D, Auld S (2010) Development and feasibility assessment of telephone-delivered supportive care to improve outcomes for patients with colorectal cancer: pilot study of the connect intervention. Support Care Cancer 18:461–470

    Article  PubMed  Google Scholar 

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Acknowledgments

Thank you to all participants who took part in this research study. Mikaela Jorgensen was funded through a postgraduate scholarship from the Cancer Institute NSW.

Conflicts of interest

None to declare.

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Authors and Affiliations

  1. Surgical Outcomes Research Centre (SOuRCe), School of Public Health, University of Sydney and Sydney South West Area Health Service, Sydney, Australia

    Mikaela L. Jorgensen, Jane M. Young, James D. Harrison & Michael J. Solomon

  2. School of Public Health, University of Sydney, Sydney, Australia

    Jane M. Young

  3. Cancer Information and Registries Division, Cancer Institute NSW, Sydney, Australia

    Jane M. Young

  4. Discipline of Surgery, University of Sydney, Sydney, Australia

    Michael J. Solomon

  5. Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, PO Box M157, Missenden Rd., Sydney, New South Wales, 2050, Australia

    Mikaela L. Jorgensen

Authors
  1. Mikaela L. Jorgensen
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  2. Jane M. Young
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  3. James D. Harrison
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  4. Michael J. Solomon
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Correspondence to Mikaela L. Jorgensen.

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Jorgensen, M.L., Young, J.M., Harrison, J.D. et al. Unmet supportive care needs in colorectal cancer: differences by age. Support Care Cancer 20, 1275–1281 (2012). https://doi.org/10.1007/s00520-011-1214-9

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  • DOI: https://doi.org/10.1007/s00520-011-1214-9

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