eP505 - The Burden of Unmet Needs in Rectal Cancer Survivors: A Single-centre Cross-sectional Study

Purpose/Background: As advances in rectal cancer treatment are made, the number of rectal cancer survivors increases. Although their cancer is cured, these patients live with longterm sequelae that impact their day-to-day lives. To date, little importance has been placed on the unmet needs of rectal cancer survivors. In other cancer types, it has been shown that the type and severity of experienced unmet needs varies based on social and environmental factors. The aim of this study was to characterize the unmet needs of rectal cancer survivors and assess the association of unmet needs with social and community factors as well as quality of life (QoL).Methods/Interventions: This was a cross-sectional study of all rectal cancer survivors who underwent primary resection (2011-2021) at a single university referral centre (REB 2019-1663). Patients were excluded if they were ≥85 years old, deceased, or unable to provide informed consent. Consenting patients completed the Short-Form Survivor Unmet Needs Survey (SF-SUNS), a sociodemographics questionnaire, and the EQ5D-5L QoL questionnaire. Tumour, disease, treatment, and post-operative variables were collected from chart review. The Material and Social Deprivation Index (MSDI) was determined based on the patient’s postal code at the time of surgery. Patients were categorized based on having no high/very high unmet needs or having ≥1 high/very high unmet needs. Descriptive statistics were used to characterize unmet needs and multivariable regression analysis was used to identify factors associated with unmet needs and the association between unmet needs and QoL.Results/Outcomes: Of 485 rectal cancer patients who underwent proctectomy, 291 were eligible for inclusion. Patients were further excluded if they declined to participate (82; 28.2%), could not be reached (42; 14.4%), did not understand English or French (44; 15,1%), or an inability to provide informed consent (5; 1.7%). Of the 118 patients in the final cohort, median survivorship time for the cohort was 45.6 (IQR 19.5-79.9) months and patients had fewer high/very high unmet needs as survivorship time increased (Figure 1). Thirty (25.4%) patients reported no high/very high unmet needs. There were no significant differences between unmet needs groups in terms of survivorship time, age, gender, and tumour characteristics. Patients with ≥1 high/very high unmet need were more often materially deprived (34.1% vs 10.3%, p=0.026777), unemployed or retired (23.3% vs 55.7%, p=0.006578), and had fewer individuals in whom they felt they could confide in (2 [IQR 2-3] vs 4 [IQR 2-5], p=0.0242) compared to those with no high/very high unmet needs. On multivariable logistic regression, the odds of having ≥1 high/very high unmet need was 2.42 (CI95% 1.17 - 18.26) times greater in materially deprived versus materially average or privileged patients. Patients with ≥1 high/very high unmet need reported significantly more problems with their usual activities (90.0% vs 70.5%, p=0.0475) as well as poorer overall QoL (75.5 [IQR 66, 85] vs 85 [IQR 80.2, 90.0], p=0.00032), the latter of which remained significant on multivariable linear regression (OR= -8.58 [CI95% -14.3, -2.32]).Conclusion/

Discussion: Unmet needs persisting throughout survivorship are prevalent and represent an important opportunity to improve care. Language spoken, ethnicity, employment status, and lack of a support network are factors associated with significant unmet needs. Screening for these factors and unmet needs at the time of surveillance visits may improve survivorship care.