Treatment experiences and decision-making among patients with metastatic colorectal cancer: Results of an online US patient survey.
Authors: Clauer Julie Saliba , Ameen Khadijah , Incudine Andrea , Newcomer Kimberley Lynn , Mulvey Amy , Steinberg Kathy , Geiger Ashley , Campbell Scott , Calabrese Ashley V. , Tejani Mohamedtaki Abdulaziz , Shah Manish A. 
Published: January 2025

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Background:
Developing treatment plans for patients (pts) with metastatic colorectal cancer (mCRC) is complex. Using an online survey, we aimed to understand the treatment experience of pts with mCRC, including pt involvement in treatment decision-making.
Methods:
Adults (≥18 yrs) with mCRC took part in an online survey conducted in the US by The Harris Poll between Jan 17 and Feb 7, 2024. Of 344 respondents, 90 were recruited from patient advocacy groups (PAGs). The 60-question survey explored pts’ experience of mCRC. We report results from questions focused on treatment. Raw data were not weighted and are only representative of the participants. All surveys are subject to sources of error.
Results:
Of 256/344 pts who received mCRC treatment, chemotherapy and surgery were the most common therapies(Table). Among pts who received therapy, 67% reported their ability to take treatment was impacted by non-medical factors such as finances or mental health. Overall, 58% of pts have had to decide between affording treatment or meeting basic needs, e.g. safe housing, food, transportation, especially Black and Hispanic pts (Table). Of all 344 pts, 87% reported reliance on their healthcare provider (HCP) when making treatment decisions, primarily their oncology surgeon (48%) or oncologist (45%), despite 268 (78%) pts carrying out independent research on new treatments or clinical trials. Although 266 pts (77%) were involved in treatment decision making, 231 pts (67%) wished for more power in the process. Overall, 64 pts (19%) wished for more support from PAGs during treatment, while 59 pts (17%) relied on PAGs to help guide treatment decisions. The most common factors affecting pt treatment decisions related to costs or insurance coverage (52%), impacts on physical health and quality of life (each 39%), fear of being a burden on family (35%), and side effects (32%).
Conclusions:
Pts with mCRC rely on their HCPs when making treatment decisions and wish for more power in the process. Personal finance and insurance coverage play dominant roles in treatment for mCRC. PAGs are an important resource for treatment information that are underutilized.

Treatment experience of pts with mCRC in an online US survey.

n (%)
All pts N=344

Black pts n=87
c

Hispanic pts n=75
c

White pts n=158

Received treatment
256 (74)
52 (60)
60 (80)
129 (82)

Chemotherapy
a

169 (66)
23 (44)
33 (55)
104 (81)

Surgery
a

147 (57)
23 (44)
32 (53)
86 (67)

Radiotherapy
a

101 (39)
25 (48)
15 (25)
52 (40)

Immunotherapy
a

72 (28)
16 (31)
20 (33)
30 (23)

Targeted therapy
a

61 (24)
12 (23)
14 (23)
30 (23)

Other
a

13 (5)
0
0
12 (9)

Stopped treatment due to overall burden
a
,b

92 (36)
28 (54)
33 (55)
27 (21)

Had to decide between treatment or basic needs
198 (58)
60 (69)
52 (69)
69 (44)

a
Among pts who received treatment.

b
Financial impact, quality of life, etc.

c
Base size <100 pts; interpret results directionally.