From:  The hidden burden: chronic sequelae of colorectal cancer survivorship and the impact on family members—a narrative review

 Dimensions of caregiver burden in colorectal cancer survivorship.

DomainTypical features in colorectal cancer caregiversIndicative prevalence/effect sizeKey references
Psychological—depression, anxiety, fear of recurrence, chronic sorrowClinically significant depressive and anxiety symptoms persisting past curative treatment
Dyadic fear of cancer recurrence; grief reactivation around milestones and scans		Depression 30–50%
Anxiety up to 50%
Elevated psychiatric hospitalization in spouses of cancer patients (HR 1.3–1.5)		[25–28, 32–35]
Relational—communication, sexuality, role strainAvoidance of difficult conversations
Sexual withdrawal; role shift with illness course
Bidirectional distress within couples		Worse dyadic adjustment with longer disease duration
Bidirectional distress within couples		[36–39]
Practical—symptom management, logisticsStoma care, toileting, medication
Appointment coordination
Information brokerage
High task intensity associated with increased subjective burden		High task intensity independently associated with increased subjective burden[6, 40, 41]
Occupational and financialWork reduction, leave, early retirement
Out-of-pocket costs, reduced household income		48% of colorectal cancer informal caregivers report high financial toxicity
25% make major employment changes		[42–44]
Physical health of caregiverSleep disturbance, somatic symptoms
Reduced self-care, delayed own health checks		Sustained burden associated with worse caregiver general and sleep health
Strongest in prolonged high-dependency caregiving		[6, 34, 40]
Social—isolation, stigmaReduced social participation
Stigma around bowel and stoma symptoms
Loneliness		Lower social support independently predicts higher caregiver distress and fear of cancer recurrence[34, 39, 45, 46]
Return to article view

HR: hazard ratio.