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User:0psychstudent0/Colorectal cancer

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Treatment

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Psychosocial Intervention

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In addition to medical intervention, a variety of psychosocial interventions have been implemented in the treatment of colorectal cancer.[1] Depression and anxiety are highly prevalent in patients diagnosed with CRC, therefore psychosocial interventions are necessary.[2][3] Many patients continue to experience symptoms of anxiety and depression following treatment, regardless of treatment outcome.[2][4] Societal stigmas associated with colorectal cancer present further psychosocial challenges for CRC patients and their families.[5][6]

Depression and Anxiety

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Colorectal cancer patients have a 51% higher risk of experiencing depression than individuals without the disease.[3] Additionally, CRC patients are at high risk of experiencing severe anxiety, low self-esteem, poor self-concept, and social anxiety.[2][7]

Post-Treatment Distress

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Regardless of treatment outcome, many CRC patients experience ongoing symptoms of anxiety, depression, and distress.[2]

Survivorship of CRC can involve significant lifestyle adjustments.[6] Postoperative afflictions may include stomas, bowel issues, incontinence, odor, and changes to sexual functioning.[6][7] These changes can result in distorted body image, social anxiety, depression, and distress—all of which contribute to a poorer quality of life.[6][8]

Colorectal cancer is the second leading cause of cancer-related death worldwide.[9] Transitioning into palliative care and contending with mortality can be a deeply distressing experience for a CRC patient and their loved ones.

Stigma

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Colorectal cancer is highly stigmatized and can elicit feelings of disgust from patients, healthcare professionals, family, intimate partners, and the general public.[5] Patients with stomas are especially vulnerable to stigmatization due to unavoidable odors, gas, and unpleasant noises from stoma bags.[5] Additonally, associated CRC risk factors like poor diet, alcohol consumption, and lack of physical activity prompt negative assumptions of blame and personal responsibility onto CRC patients.[6] Judgement from others along with internalized self-blame and embarrassment can negatively affect self-esteem, sociability, and quality of life.[6]

Methods of Intervention

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Face-to-face interventions such as clinician-patient talk therapy, body-mind-spirit practices, and support group sessions have been identified as most effective in reducing anxiety and depression in CRC patients.[1] Additionally, journaling exercises and over-the-phone talk therapy sessions have been implemented.[1] Though deemed less effective, these non-face-to-face interventions are economically inclusive and have been found to reduce both depression and anxiety in CRC patients.[1]

Early Onset Colorectal Cancer (EOCC)

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A diagnosis of colorectal cancer in patients under 50 years of age is referred to as Early Onset Colorectal Cancer (EOCC).[9][10]Instances of EOCC have increased over the last decade, specifically in patient populations aged 20-40 years old throughout North America, Europe, Australia, and China.[10][11]

Incidence by Age

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Incidences of colorectal cancer in younger populations have increased over the last decade.[9][10][11]While advancements in diagnostic procedure may have some impact, reduced likelihood of screening among these populations suggests detection bias is not a major contributor to this trend. More likely, cohort-effects are at play.[11]

The population experiencing the greatest rise in EOCC cases are men and women aged 20-29 years old, with incidences increasing by 7.9% a year between 2004 and 2016.[11] Similarly, though less severe, men and women aged 30-39 experienced an increase in cases at a rate of 3.4% a year during that same time period. Despite these increases, the mortality rate for colorectal cancer has remained the same.[11]

Risk Factors

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Risk factors associated with EOCC are akin to those of all colorectal cancer cases.[10] Observed cohort-effects are likely the product of generational shifts in lifestyle and environmental factors.[9][10]

Preventative Screening

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In 2018, the American Cancer Society modified their previous screening guideline for colorectal cancer from age 50 down to age 45 following the recognition of increasing cases of EOCC.[11] Individuals under the age of 60 have been identified as most susceptible to non-participation in colorectal cancer screening.[12]

  1. ^ a b c d Son, Heesook; Son, Youn-Jung; Kim, Hyerang; Lee, Yoonju (2018-06-08). "Effect of psychosocial interventions on the quality of life of patients with colorectal cancer: a systematic review and meta-analysis". Health and Quality of Life Outcomes. 16 (1): 119. doi:10.1186/s12955-018-0943-6. ISSN 1477-7525. PMC 5994008. PMID 29884182.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  2. ^ a b c d Peng, Yu-Ning; Huang, Mei-Li; Kao, Chia-Hung (2019-01-31). "Prevalence of Depression and Anxiety in Colorectal Cancer Patients: A Literature Review". International Journal of Environmental Research and Public Health. 16 (3): 411. doi:10.3390/ijerph16030411. ISSN 1660-4601. PMC 6388369. PMID 30709020.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  3. ^ a b Cheng, Vicki; Oveisi, Niki; McTaggart-Cowan, Helen; Loree, Jonathan M.; Murphy, Rachel A.; De Vera, Mary A. (2022). "Colorectal Cancer and Onset of Anxiety and Depression: A Systematic Review and Meta-Analysis". Current Oncology. 29 (11): 8751–8766. doi:10.3390/curroncol29110689. ISSN 1718-7729. PMC 9689519. PMID 36421342.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  4. ^ Mosher, Catherine E.; Winger, Joseph G.; Given, Barbara A.; Helft, Paul R.; O'Neil, Bert H. (2016). "Mental health outcomes during colorectal cancer survivorship: a review of the literature: Mental health in colorectal cancer survivorship". Psycho-Oncology. 25 (11): 1261–1270. doi:10.1002/pon.3954. PMC 4894828. PMID 26315692.{{cite journal}}: CS1 maint: PMC format (link)
  5. ^ a b c Reynolds, Lisa M.; Consedine, Nathan S.; Pizarro, David A.; Bissett, Ian P. (2013). "Disgust and Behavioral Avoidance in Colorectal Cancer Screening and Treatment: A Systematic Review and Research Agenda". Cancer Nursing. 36 (2): 122–130. doi:10.1097/NCC.0b013e31826a4b1b. ISSN 0162-220X.
  6. ^ a b c d e f Phelan, Sean M.; Griffin, Joan M.; Jackson, George L.; Zafar, S. Yousuf; Hellerstedt, Wendy; Stahre, Mandy; Nelson, David; Zullig, Leah L.; Burgess, Diana J.; van Ryn, Michelle (2013). "Stigma, perceived blame, self‐blame, and depressive symptoms in men with colorectal cancer". Psycho-Oncology. 22 (1): 65–73. doi:10.1002/pon.2048. ISSN 1057-9249. PMC 6000725. PMID 21954081.{{cite journal}}: CS1 maint: PMC format (link)
  7. ^ a b Hoon, Lim Siew; Chi Sally, Chan Wai; Hong-Gu, He (2013). "Effect of psychosocial interventions on outcomes of patients with colorectal cancer: A review of the literature". European Journal of Oncology Nursing. 17 (6): 883–891. doi:10.1016/j.ejon.2013.05.001. ISSN 1462-3889.
  8. ^ Meng, Xinyu; Wang, Xiaodong; Dong, Zaiquan (2021-10-01). "Impact of non-pharmacological interventions on quality of life, anxiety, and depression scores in patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials". Supportive Care in Cancer. 29 (10): 5635–5652. doi:10.1007/s00520-021-06185-x. ISSN 1433-7339.
  9. ^ a b c d Hua, Hongmei; Jiang, Qiuping; Sun, Pan; Xu, Xing (2023-05-05). "Risk factors for early-onset colorectal cancer: systematic review and meta-analysis". Frontiers in Oncology. 13. doi:10.3389/fonc.2023.1132306. ISSN 2234-943X.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ a b c d e Puzzono, Marta; Mannucci, Alessandro; Grannò, Simone; Zuppardo, Raffaella Alessia; Galli, Andrea; Danese, Silvio; Cavestro, Giulia Martina (2021). "The Role of Diet and Lifestyle in Early-Onset Colorectal Cancer: A Systematic Review". Cancers. 13 (23): 5933. doi:10.3390/cancers13235933. ISSN 2072-6694. PMC 8657307. PMID 34885046.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  11. ^ a b c d e f Vuik, Fanny ER; Nieuwenburg, Stella AV; Bardou, Marc; Lansdorp-Vogelaar, Iris; Dinis-Ribeiro, Mário; Bento, Maria J; Zadnik, Vesna; Pellisé, María; Esteban, Laura; Kaminski, Michal F; Suchanek, Stepan; Ngo, Ondřej; Májek, Ondřej; Leja, Marcis; Kuipers, Ernst J (2019). "Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years". Gut. 68 (10): 1820–1826. doi:10.1136/gutjnl-2018-317592. ISSN 0017-5749. PMC 6839794. PMID 31097539.{{cite journal}}: CS1 maint: PMC format (link)
  12. ^ Unanue-Arza, Saloa; Solís-Ibinagagoitia, Maite; Díaz-Seoane, Marta; Mosquera-Metcalfe, Isabel; Idigoras, Isabel; Bilbao, Isabel; Portillo, Isabel (2020-12-12). "Inequalities and risk factors related to non-participation in colorectal cancer screening programmes: a systematic review". The European Journal of Public Health. 31 (2): 346–355. doi:10.1093/eurpub/ckaa203. ISSN 1101-1262. PMC 8071594. PMID 33313657.