Priorities of Unmet Needs for Those Affected by Colorectal Cancer: Considerations From a Series of Nominal Group Technique Sessions

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Sharyn F. Worrall Fight Colorectal Cancer, Springfield, Missouri; and

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Andrea J. Dwyer University of Colorado Cancer Center, Colorado School of Public Health, Aurora, Colorado.

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Reese M. Garcia Fight Colorectal Cancer, Springfield, Missouri; and

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Keavy E. McAbee Fight Colorectal Cancer, Springfield, Missouri; and

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Anjelica Q. Davis Fight Colorectal Cancer, Springfield, Missouri; and

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Background: Colorectal cancer (CRC) is the third most common cancer among men and women in the United States. Patients and survivors experience a range of challenges, including anxiety, financial issues, long-term adverse effects, and more. The intent of this project was to assess the needs of the CRC community directly from survivors and their caregivers and to lay a foundation for ongoing support. Methods: Twelve nominal group technique sessions were facilitated. Participants were randomized and presented with the following questions: “What information do you wish you had at the time of diagnosis?” and “What information do you need now as a survivor?” After the nominal group technique process, each statement’s score was divided by the number of people in the session, providing the average to identify the top-ranked statements. Themes and subthemes were applied to statements. Results were compared between coders. Results: There was a total of 79 participants, 49 of whom self-identified as a patient with or survivor of cancer. Patient/survivor demographics were as follows: stage IV disease (n=20), stage III disease (n=22), stage II disease (n=5), stage I disease (n=2), caregiver/family member (n=30), male (n=16), female (n=63), White (n=50), Native Hawaiian/Pacific Islander (n=1), Hispanic/Latino (n=13), Black/African American (n=11), Asian (n=1), and more than one race/ethnicity (n=3). The most frequent themes among responses to the first question were communication and coordination with care team and access to CRC resources. The most frequent themes among responses to the second question were psychosocial support and family/caregiver support. Frequent themes among responses across both questions were understanding treatment options and adverse effects. Conclusions: These findings highlight gaps in support for individuals affected by CRC, and lay a foundation for ongoing assistance. Future studies exploring differences based on disease stage, race/ethnicity, age, gender identity, geographic location, and tumor location are needed to further tailor support for those experiencing CRC. Themes identified in this project require a multidisciplinary approach to ensure that the unmet needs of survivors are addressed.

Submitted April 25, 2020; final revisions received August 27, 2020; accepted for publication September 21, 2020.

Published online February 19, 2021

Author contributions: Study concept: Dwyer, McAbee, Davis. Data collection: Worrall, Dwyer, Garcia. Data analysis and interpretation: Worrall, Garcia. Manuscript preparation: Worrall. Critical revision: Dwyer. Final approval: Dwyer, Davis.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.

Correspondence: Sharyn F. Worrall, MPH, Fight Colorectal Cancer, 134 Park Central Square, Suite 210, Springfield, MO 65806. Email: Sharyn.f.g@gmail.com
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