BACKGROUND: The incidence of early-onset colorectal cancer is rising, yet survivorship care guidelines rarely address concerns unique to younger adults. Although treatment for colorectal cancer can have devastating consequences to sexual function and fertility, these issues remain under-recognized and seldom addressed. OBJECTIVE: To better understand the impact of colorectal cancer diagnosis and treatment on sexual and reproductive health. DESIGN: Qualitative study of patients with early-onset colorectal cancer. SETTINGS: Semi-structured one-on-one zoom interviews of patients recruited through convenience sampling from 7 academic institutions. PATIENTS: Sixty-three individuals diagnosed with colorectal cancer before age 50 were interviewed between March 2021 and August 2024. MAIN OUTCOME MEASURES: Patient perspectives of sexual and reproductive health impacts of colorectal cancer diagnosis and treatment. Data were analyzed iteratively using directed and conventional qualitative content analysis. RESULTS: Participants discussed sexual and reproductive health side effects resulting from surgery, chemotherapy, and radiation. These side effects ranged in severity, with some experiencing almost none and others facing significant issues. They identified several domains, including surgical and treatment side effects, psychological impacts, effects on relationships, and unmet needs. Subdomains included sexual health, reproductive health, emotional distress, body image, communication challenges, impacts on dating, informational needs, financial support, and consultations. LIMITATIONS: Participants were recruited from academic medical centers only, and as such responses may not reflect the experiences of those cared for in non-academic settings. CONCLUSION: Sexual and reproductive health are critical but often overlooked concerns among younger patients with CRC, with significant impacts on physical functioning, partner relationships, and psychological well-being. Current survivorship guidelines fail to adequately address these needs. Our findings highlight the importance of pretreatment counseling and fertility preservation as well as the need for ongoing mental health support during and after cancer treatment. (See Video Abstract )
Savitch et al. (Thu,) studied this question.