Impact of early onset colorectal cancer on mental and physical health: A comparative analysis of self-reported mental and physical health outcomes using the PROMIS framework in the NIH All of Us Research Program.

241 Background: Patients with early-onset colorectal cancer (EOCRC) have complex psycho-social needs that can impact their overall health and well-being. With the increasing incidence of EOCRC, it is essential to investigate the effects of this diagnosis on patients' mental and physical health. This study uses the Patient-Reported Outcomes Measurement Information System (PROMIS) framework to compare patients' self-reported mental and physical health perceptions with EOCRC and those with late-onset colorectal cancer (LOCRC). Methods: We utilized the National Institutes of Health's (NIH) All of Us database Registered Tier Dataset v7, which includes 266,520 participants who agreed to share their EHR information, for analysis. Participants completed PROMIS surveys for physical health (PROMIS-PH) and mental health (PROMIS-MH). We categorized patients with colorectal cancer into EOCRC (age at diagnosis <50) and LOCRC (age at diagnosis >=50) using ICD 9/10 codes. We calculated the raw summed scores for PROMIS-PH and PROMIS-MH for each group. We transformed the raw summed score into a T-score. The study compared scores in EOCRC and LOCRC using the Mann-Whitney U test with a significance level of P<0.05. We used the R programming language in the web-based Jupyter Notebook platform for data analysis. Results: Our study revealed 1764 colorectal cancer patients, with 408 cases of EOCRC (mean age of onset: 42.13 years, SD: 7.0) and 1356 cases of LOCRC (mean age: 63.72 years, SD: 8.35). Analysis of PROMIS Global scores showed that EOCRC patients had a mean PROMIS-MH score of 13.90 (SD: 3.42, T-score: 45.8, 95% CI: 38.74-52.86) and mean PROMIS-PH score of 13.95 (SD: 3.38, T-score: 42.3, 95% CI: 34.07-50.53). In contrast, LOCRC patients had mean PROMIS-MH and PROMIS-PH scores of 14.47 (SD: 3.37, T-score: 48.3, 95% CI: 41.05-55.55) and 14.24 (SD: 3.35, T-score: 44.9, 95% CI: 36.47-53.33), respectively. The PROMIS-MH scores were significantly higher in LOCRC than in EOCRC (p-value <0.001). However, there was no significant difference between the PROMIS-PH scores in both groups (p-value= 0.191). Conclusions: The study suggests that patients with EOCRC have a lower level of perceived mental health compared to LOCRC. Also, the EOCRC had a lower level of perceived physical health, although not statistically significant. These findings emphasize the significance of age-specific approaches in cancer research and underscore the importance of focused interventions to meet the unique mental and physical health needs of patients with EOCRC.