Background/Aim
Structured exercise improves survival outcomes in colorectal cancer, with the CHALLENGE trial demonstrating a 28% reduction in recurrence risk and 37% decrease in overall mortality. However, access to exercise oncology services remains inconsistent, particularly for younger patients facing competing demands such as employment, caregiving, and treatment-related appointment burden. The Strength Squad is a fully funded exercise physiology program for young-onset colorectal cancer patients, delivered in-person in South Yarra and online across Australia and New Zealand. Despite removing financial cost as a barrier, attendance rates suggest cost alone does not guarantee engagement. This study aimed to identify the specific barriers young cancer survivors face when engaging in a specialist exercise program, and possible solutions to increase physical activity.
Methods
Program registration, session attendance, and completion data were extracted from PracSuite and The Strength Squad website registration form for participants enrolled between November 2025 and July 2026 (n=59). A survey was administered to registered but non-attending participants to identify barriers to engagement, supplemented by in-person and online assessment data for participants who completed assessment but were non-adherent to group or individual sessions.
Results
Of 59 registered participants, 61% (n=36) attended at least one session, and 13.5% (n=8) completed the full 26-session program. Among non-attending or non-completing participants, the most commonly reported barriers were work-related (39%), family/caregiving responsibilities (28%), and treatment-related side effects (11%).
Conclusion
Removing financial cost did not eliminate barriers to exercise program engagement for young-onset colorectal cancer patients, who continue to face significant work, family, and treatment-related burdens. These findings suggest exercise oncology services for this population require flexible scheduling, shorter sessions, and individual formats to improve real-world accessibility beyond addressing cost alone. The Strength Squad has since introduced individual sessions to offer greater scheduling variety and a more comfortable entry point for those new to exercise.