Exploring the Lived Experiences of Colorectal Cancer Patients With Diagnosis and Treatment in Egypt: A Qualitative Interview Study

Abstract

PURPOSE Colorectal cancer (CRC) is a major health challenge in Egypt with an alarming 46.4% early-onset rate in people younger than 50 years and an overall 2 years of survival post-diagnosis. Understanding patient's experiences is necessary to enhance health outcomes. This study aims to explore patients' lived experiences of diagnoses, treatment, and perceptions of a healthy diet and physical activity. METHODS The Social Ecological Model (SEM), exploring variable-specific barriers and facilitators at individual, interpersonal, organizational, community, and policy levels, served as our theoretical framework. One-hour, face-to-face, semi-structured interviews were conducted with CRC patients in Alexandria, Egypt, between August and September 2023. Audio recorded interviews were transcribed and analyzed by thematic analysis. RESULTS Our study involved 19 participants;12 males and 7 females with a mean age of 53 years. All participants came from low-income backgrounds, 70% were urban residents, 80% were unemployed, and 52% were either illiterate or had not completed their primary education. Nearly half of the participants were in advanced cancer stage (stage 3 or higher). We identified facilitators and barriers to optimal care in patients experiences at several levels of the SEM. The main barriers were as follows: at the individual level, lack of CRC awareness and neglect of symptoms, fear of colonoscopy, loss of appetite, decreased physical activity, and being unemployed during treatment; at the health services organization level, misdiagnosis, negative colonoscopy experiences, and a lack of comprehensive treatment guidance. The main facilitators perceived by the participants were as follows: at the individual level, resilience in accepting diagnosis and treatment, and appreciation of the healthcare team; at the interpersonal level, social support from family, neighbors, and other patients; at the health services organization level, seamless and free access to oncology care, provider recommendations for a healthy diet and physical activity; and at the community level, religious faith in accepting one's destiny. CONCLUSION The findings of this study emphasize the need for early detection of CRC through screening programs and health campaigns for cancer symptoms awareness. It is also crucial to improve healthcare teams' communication with patients to ensure a higher likelihood of a positive experience.