Clinical Characteristics, Psychosocial Concerns, and Supportive Care Needs in Young Adults with Colorectal Cancer

The incidence of colorectal cancer (CRC) in adolescents and young adults is increasing, and affected individuals often face diagnostic delays, psychological distress, fertility-related concerns, and limited access to social support. Few studies have evaluated these multidimensional factors. This study aimed to clarify the clinical characteristics, psychosocial burden, fertility-related issues, and support needs of young adults with CRC.

Patients aged 15-39 years diagnosed with CRC between 2012 and 2025 were evaluated. Clinical characteristics, psychological distress, fertility-related concerns, and utilization of social support resources were assessed using medical records, nursing documentation, multidisciplinary reports, and institutional assessment tools. Documented psychological and fertility concerns were categorized, and survival outcomes were estimated using the Kaplan-Meier method.

Symptom-driven diagnosis occurred in 59.2% overall and was significantly more common in patients in their 20 seconds (91.7% vs 52.5%, p = 0.011). Screening-based detection was lower in the 20 seconds (16.7%) than in the 30 seconds (49.2%, p = 0.039). Advanced disease (Stage II-IV) accounted for 56.3% of cases and was associated with poorer survival (p = 0.013). Psychological distress was documented in 77.5% of patients. Fertility-related anxiety occurred in 22.5% and was more frequent in women (35.5% vs 12.5%, p = 0.022). Fertility preservation was performed in 9.9%. Social worker involvement was noted in 66.2%, while use of public support systems remained low.

Young adults with CRC face delayed diagnosis, substantial psychological distress, sex-specific fertility concerns, and limited engagement with public support programs. Improved symptom recognition, routine distress screening, gender-inclusive fertility counseling, and strengthened multidisciplinary support are needed for this population.