Feasibility of survey-based data collection in a diverse colorectal cancer cohort: Early-onset vs. average-onset

BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC) is rising, yet a robust model of underlying factors across diverse populations is unknown. Most studies have examined a single factor or were performed in non-diverse population. The collection of comprehensive, patient-reported data across different populations in CRC will enable a deeper understanding of these associations to inform early intervention strategies. METHODS: A pilot survey study was conducted at UT Southwestern Simmons Comprehensive Cancer Center (SCCC) and its affiliated safety-net hospital, Parkland Health and Hospital System (PHHS). The objective was to evaluate the feasibility of a multidomain survey in colorectal cancer patients. Eligible patients (≥18 years, stage I-IV adenocarcinoma, diagnosed within 12 months) completed baseline surveys in English or Spanish on demographics, lifestyle, symptom burden, nutrition (Dietary History Questionnaire), quality of life (EORTC QLQ-30, CR29), and financial toxicity (COST-FACIT). Surveys were administered in REDCap at baseline and three months follow-up. The primary endpoint was survey completion; feasibility was assessed by recruitment, participation, and completion rates. Descriptive comparisons were made between EOCRC (<50 years) and average-age onset colorectal cancer (AOCRC; ≥50 years). RESULTS: From March 2024 to April 2025, 66 patients were approached, and 60 (91%) consented; all completed the baseline survey (100%), confirming feasibility across academic and safety-net settings. However, for the three-month follow-up survey participation decreased by 50%. The cohort was evenly distributed by sex (48% female, 52% male) and site (50% Parkland, 50% UTSW). Participants were diverse (42% Hispanic, 18% Black, 42% Non-Hispanic White) with variable socioeconomic status: 38% reported income <$35,000, 23% >$100,000, 28% were unable to work, and 23% were employed. Hospital utilization differed: 96% of Non-Hispanic Whites were treated at SCCC, while most Hispanic and Black patients were seen at PHHS. Parkland Financial Assistance was reported by 77%, highest among Hispanic patients. Nineteen patients (32%) had EOCRC (median age 42, range 30-48) and 41 (68%) had AOCRC (median age 64, range 51-82). EOCRC patients were more often Hispanic (58% vs. 32%), treated at Parkland (58% vs. 46%), and received assistance more frequently (47% vs. 34%). CONCLUSION: This pilot study confirms that comprehensive, survey-based data collection is feasible in a racially, ethnically, and financially diverse CRC cohort. These preliminary findings highlight the clinical and sociodemographic differences of EOCRC and AOCRC across distinct groups. Future work will expand longitudinal follow-up, incorporate electronic health record data, and leverage tumor registry phenotypes to enable low-touch, systematic patient recruitment for a more robust sample.