Anne M Walling1, Jane C Weeks2, Katherine L Kahn3, Diana Tisnado4, Nancy L Keating5, Sydney M Dy6, Neeraj K Arora7, Jennifer W Mack8, Philip M Pantoja9, Jennifer L Malin9. 1. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, California, USA; Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA; RAND Health, Santa Monica, California, USA. Electronic address: awalling@mednet.ucla.edu. 2. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Health Policy and Management, Harvard Medical School, Boston, Massachusetts, USA; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. 3. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, California, USA; RAND Health, Santa Monica, California, USA. 4. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, California, USA; Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA. 5. Division of General Internal Medicine, Brigham and Women's Hospital, Boston; Department of Health Care Policy, Harvard Medical School, Boston, Maryland, USA. 6. Johns Hopkins Kimmel Cancer Center, Baltimore, Maryland, USA. 7. Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA. 8. Department of Health Policy and Management, Harvard Medical School, Boston, Massachusetts, USA. 9. Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA.
Abstract
CONTEXT: Relatively few data are available about symptoms among cancer patients. OBJECTIVES: To describe the prevalence and severity of symptoms among a large, representative cohort of newly diagnosed cancer patients. METHODS: We collected survey data about symptoms (pain, fatigue, depression, nausea/vomiting, cough, dyspnea, and diarrhea) from 5422 patients with incident lung and colorectal cancer from the diverse, nationally representative Cancer Care Outcomes Research and Surveillance Consortium cohort. We described the prevalence of any symptoms and moderate/severe symptoms approximately four to six months after diagnosis. We used logistic regression to identify patient and clinical characteristics associated with symptoms, and calculated adjusted proportions of patients with symptoms. RESULTS: In total, 5067 (93.5%) patients reported at least one symptom in the four weeks before their survey, with 51% reporting at least one moderate/severe symptom. Lung cancer patients reported more symptoms than colorectal cancer patients. Patients who received treatment or had more comorbidities were more likely to report symptoms. For example, after adjustment, patients who received chemotherapy during the six weeks before the survey were more likely than others to report at least one symptom (97.3% vs. 90.8%, P<0.001), and at least one moderate/severe symptom (56.8% vs. 46.2%, P<0.001). After adjustment, early- vs. late-stage patients did not differ in reports of at least one symptom (93.6% vs. 93.4%, P=0.853) and differed only slightly in reports of at least one moderate/severe symptom (53.3% vs. 49.6%, P=0.009). CONCLUSION: Most recently diagnosed lung and colorectal cancer patients have cancer-related symptoms regardless of stage, and more than half have at least one moderate/severe symptom. Published by Elsevier Inc.
CONTEXT: Relatively few data are available about symptoms among cancerpatients. OBJECTIVES: To describe the prevalence and severity of symptoms among a large, representative cohort of newly diagnosed cancerpatients. METHODS: We collected survey data about symptoms (pain, fatigue, depression, nausea/vomiting, cough, dyspnea, and diarrhea) from 5422 patients with incident lung and colorectal cancer from the diverse, nationally representative Cancer Care Outcomes Research and Surveillance Consortium cohort. We described the prevalence of any symptoms and moderate/severe symptoms approximately four to six months after diagnosis. We used logistic regression to identify patient and clinical characteristics associated with symptoms, and calculated adjusted proportions of patients with symptoms. RESULTS: In total, 5067 (93.5%) patients reported at least one symptom in the four weeks before their survey, with 51% reporting at least one moderate/severe symptom. Lung cancerpatients reported more symptoms than colorectal cancerpatients. Patients who received treatment or had more comorbidities were more likely to report symptoms. For example, after adjustment, patients who received chemotherapy during the six weeks before the survey were more likely than others to report at least one symptom (97.3% vs. 90.8%, P<0.001), and at least one moderate/severe symptom (56.8% vs. 46.2%, P<0.001). After adjustment, early- vs. late-stage patients did not differ in reports of at least one symptom (93.6% vs. 93.4%, P=0.853) and differed only slightly in reports of at least one moderate/severe symptom (53.3% vs. 49.6%, P=0.009). CONCLUSION: Most recently diagnosed lung and colorectal cancerpatients have cancer-related symptoms regardless of stage, and more than half have at least one moderate/severe symptom. Published by Elsevier Inc.
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