{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T18:17:48Z","timestamp":1783189068342,"version":"3.54.6"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Adolescent and Young Adult Oncology"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>Patients aged 15\u201339 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\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Symptom-driven diagnosis occurred in 59.2% overall and was significantly more common in patients in their 20 seconds (91.7% vs 52.5%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.011). Screening-based detection was lower in the 20 seconds (16.7%) than in the 30 seconds (49.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.039). Advanced disease (Stage II\u2013IV) accounted for 56.3% of cases and was associated with poorer survival (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 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%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21565333261464965","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T10:26:37Z","timestamp":1782987997000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics, Psychosocial Concerns, and Supportive Care Needs in Young Adults with Colorectal Cancer"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5208-554X","authenticated-orcid":false,"given":"Hayato","family":"Yamaguchi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."},{"name":"Hayabusa Internal Medicine Home Clinic, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakatsu","family":"Fukuzawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kawai","sequence":"additional","affiliation":[{"name":"Endoscopy Center, Tokyo Medical University Hospital, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Muzumachi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Ida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumito","family":"Yamanishi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Ichimiya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Nemoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Muramatsu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Kagawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumiko","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Madarame","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Morise","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiya","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Kono","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakiko","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Itoi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21395"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2014.0006"},{"issue":"6","key":"e_1_3_3_4_1","first-page":"1205","article-title":"Global trends in colorectal cancer incidence and mortality in young adults","volume":"70","author":"Araghi M","year":"2021","unstructured":"3.Araghi M, , Soerjomataram I, , Jenkins M, et al. Global trends in colorectal cancer incidence and mortality in young adults. Gut 2021;70(6):1205\u20131212.","journal-title":"Gut"},{"issue":"25","key":"e_1_3_3_5_1","first-page":"2812","article-title":"Colorectal cancer in the young","volume":"28","author":"Patel SG","year":"2022","unstructured":"4.Patel SG, , Ahnen DJ. Colorectal cancer in the young. World J Gastroenterol 2022;28(25):2812\u20132830.","journal-title":"World J Gastroenterol"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26056"},{"issue":"17","key":"e_1_3_3_7_1","first-page":"4884","article-title":"Unmet adolescent and young adult cancer survivors\u2019 supportive care needs","volume":"118","author":"Keegan THM","year":"2012","unstructured":"6.Keegan THM, , Lichtensztajn DY, , Kato I, et al. Unmet adolescent and young adult cancer survivors\u2019 supportive care needs. Cancer 2012;118(17):4884\u20134895.","journal-title":"Cancer"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.2462"},{"issue":"30","key":"e_1_3_3_9_1","first-page":"2758","article-title":"Clinical and molecular characterization of early-onset colorectal cancer","volume":"37","author":"Willauer AN","year":"2019","unstructured":"8.Willauer AN, , Liu Y, , Pereira AA, et al. Clinical and molecular characterization of early-onset colorectal cancer. J Clin Oncol 2019;37(30):2758\u20132767.","journal-title":"J Clin Oncol"},{"key":"e_1_3_3_10_1","first-page":"1441","article-title":"Colorectal cancer in younger adults\u2014insights into screening and management","volume":"382","author":"O\u2019Neil BH","year":"2020","unstructured":"9.O\u2019Neil BH, , Goldberg RM. Colorectal cancer in younger adults\u2014insights into screening and management. N Engl J Med 2020;382:1441\u20131443.","journal-title":"N Engl J Med"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.030"},{"issue":"17","key":"e_1_3_3_12_1","first-page":"2181","article-title":"Psychological distress and quality of life in young adult cancer survivors","volume":"31","author":"Wong AW","year":"2013","unstructured":"11.Wong AW, , Abramson K, , Flynn KE, et al. Psychological distress and quality of life in young adult cancer survivors. J Clin Oncol 2013;31(17):2181\u20132189.","journal-title":"J Clin Oncol"},{"issue":"7","key":"e_1_3_3_13_1","first-page":"1408","article-title":"A systematic review of fertility-related concerns, needs, and experiences of adolescent and young adult cancer survivors","volume":"28","author":"Logan S","year":"2019","unstructured":"12.Logan S, , Perz J, , Ussher JM, et al. A systematic review of fertility-related concerns, needs, and experiences of adolescent and young adult cancer survivors. Psychooncology 2019;28(7):1408\u20131420.","journal-title":"Psychooncology"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.49.2678"},{"issue":"5","key":"e_1_3_3_15_1","first-page":"157","article-title":"Patient-physician communication barriers regarding fertility preservation","volume":"13","author":"Quinn GP","year":"2015","unstructured":"14.Quinn GP, , Vadaparampil ST, , Bell-Ellison BA, et al. Patient-physician communication barriers regarding fertility preservation. J Community Support Oncol 2015;13(5):157\u2013165.","journal-title":"J Community Support Oncol"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.09.013"},{"issue":"30","key":"e_1_3_3_17_1","first-page":"3212","article-title":"Economic burden of cancer survivorship among adolescents and young adults","volume":"32","author":"Guy GP","year":"2014","unstructured":"16.Guy GPJr, , Yabroff KR, , Ekwueme DU, et al. Economic burden of cancer survivorship among adolescents and young adults. J Clin Oncol 2014;32(30):3212\u20133220.","journal-title":"J Clin Oncol"},{"issue":"17","key":"e_1_3_3_18_1","first-page":"4896","article-title":"Adolescent and young adult cancer survivors: Unmet needs and the transition to survivorship","volume":"118","author":"Kent EE","year":"2012","unstructured":"17.Kent EE, , Parry C, , Montoya MJ, et al. Adolescent and young adult cancer survivors: Unmet needs and the transition to survivorship. Cancer 2012;118(17):4896\u20134903.","journal-title":"Cancer"},{"issue":"7","key":"e_1_3_3_19_1","first-page":"1029","article-title":"Financial toxicity in young adults with cancer: A systematic review","volume":"26","author":"Gordon LG","year":"2017","unstructured":"18.Gordon LG, , Walker SM, , Merven M, et al. Financial toxicity in young adults with cancer: A systematic review. Psychooncology 2017;26(7):1029\u20131039.","journal-title":"Psychooncology"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.5467"},{"key":"e_1_3_3_21_1","first-page":"573","article-title":"Psychosocial issues in young-onset colorectal cancer: A scoping review","volume":"40","author":"Khoo AMG","year":"2022","unstructured":"20.Khoo AMG, et al. Psychosocial issues in young-onset colorectal cancer: A scoping review. J Psychosoc Oncol 2022;40:573\u2013588.","journal-title":"J Psychosoc Oncol"}],"container-title":["Journal of Adolescent and Young Adult Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21565333261464965","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21565333261464965","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21565333261464965","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T17:47:14Z","timestamp":1783187234000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21565333261464965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":20,"alternative-id":["10.1177\/21565333261464965"],"URL":"https:\/\/doi.org\/10.1177\/21565333261464965","relation":{},"ISSN":["2156-5333","2156-535X"],"issn-type":[{"value":"2156-5333","type":"print"},{"value":"2156-535X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"article-number":"21565333261464965"}}