Use of the Survivors’ Unmet Needs Survey (SUNS) Framework to Understand the Needs of Colorectal Cancer Survivors in Thailand: A Qualitative Descriptive Study

Abstract

Background: A significant body of research has identified ongoing unmet needs among cancer survivors. However, there is limited information about the survivorship experiences of patients in low- and middle-income countries. This study examined the experiences of colorectal cancer (CRC) survivors in Thailand to understand their post-treatment needs and priorities. Methods: A qualitative descriptive study using semi-structured interviews was conducted with 24 colorectal cancer survivors purposively recruited from a large university hospital in Bangkok, Thailand. The interviews lasted 60–90 min, were audio-recorded, and transcribed verbatim. The data were analyzed using hybrid content analysis, guided by the five domains of the Survivors Unmet Needs Survey (SUNS): information, emotional health, financial concerns, access and continuity of care, and relationships. Results: Participants had a mean age of 57 (SD = 10.9) years. Most were male (58.3%) and diagnosed at a late stage (62.5%). All participants had undergone surgical treatment, and the average time since treatment completion was approximately 3.85 (SD = 2.8) years. Participants most often reported unmet needs in the information and emotional health domains. They also described inadequate physical infrastructure (e.g., overcrowded clinic spaces) and minimal involvement of multidisciplinary providers. Despite these challenges, survivors expressed strong trust in physicians and a preference for physician-led care. Telehealth was viewed as a potential solution to reduce access barriers and improve continuity of care. Conclusions: Guided by the SUNS framework, this study identified significant unmet needs among colorectal cancer survivors in Thailand, particularly in health information, psychological support, and care system infrastructure. Strengthening health information delivery, establishing dedicated survivorship clinics, and exploring scalable care models supported by telehealth could help bridge these gaps and promote more equitable survivorship care in low-resource settings.