Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research

Chloe Yi Shing Lim; Rebekah Clare Laidsaar-Powell; Jane M Young; Steven Chuan-Hao Kao; Yuehan Zhang; Phyllis Butow

doi:10.1111/ecc.13421

Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research

Eur J Cancer Care (Engl). 2021 Jul;30(4):e13421. doi: 10.1111/ecc.13421. Epub 2021 Mar 18.

Authors

Chloe Yi Shing Lim¹, Rebekah Clare Laidsaar-Powell¹, Jane M Young^{2

3}, Steven Chuan-Hao Kao^{4

5}, Yuehan Zhang⁶, Phyllis Butow¹

Affiliations

¹ Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
² Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
³ RPA Institute of Academic Surgery (IAS) and Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia.
⁴ Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.
⁵ Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
⁶ National Centre for Epidemiology and Population Health, Australian National University Research School of Population Health, Canberra, ACT, Australia.

PMID: 33733545
DOI: 10.1111/ecc.13421

Abstract

Introduction: With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early-stage and advanced CRC survivors.

Methods: CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis.

Results: Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early-stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas.

Conclusion: CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment-specific impacts on QoL and long-term (>5 years) impacts on CRC survivors.

Keywords: cancer; colorectal; qualitative; survivorship; systematic review; thematic synthesis.

Publication types

Review
Systematic Review

MeSH terms

Cancer Survivors*
Colorectal Neoplasms* / therapy
Humans
Qualitative Research
Quality of Life
Survivorship

Abstract

Publication types

MeSH terms

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