Unmet supportive care needs in colorectal cancer: Differences by age

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.