Laura E Davis1, Lev D Bubis2, Alyson L Mahar3, Qing Li4, Jonathan Sussman5, Lesley Moody6, Lisa Barbera7, Claire Mb Holloway8, Natalie G Coburn9. 1. Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada. 2. Division of General Surgery, Department of Surgery, University of Toronto, Stewart Building, 149 College St., 5th Floor, Toronto, Ontario, M5T 1P5, Canada. 3. Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada; Division of General Surgery, Department of Surgery, University of Toronto, Stewart Building, 149 College St., 5th Floor, Toronto, Ontario, M5T 1P5, Canada. 4. Institute for Clinical Evaluative Sciences, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada. 5. Cancer Care Ontario, 620 University Ave., Toronto, Ontario, Canada, M5G 2L7; Department of Oncology, McMaster University, 1280 Main St. W., Hamilton, Ontario, L8S 4L8, Canada. 6. Cancer Care Ontario, 620 University Ave., Toronto, Ontario, Canada, M5G 2L7; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St., Toronto, Ontario, M5T 3M6, Canada. 7. Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada; Cancer Care Ontario, 620 University Ave., Toronto, Ontario, Canada, M5G 2L7; Department of Radiation Oncology, University of Toronto, FitzGerald Building, 150 College St., Toronto, Ontario, M5S 3E2, Canada. 8. Cancer Care Ontario, 620 University Ave., Toronto, Ontario, Canada, M5G 2L7; Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada. 9. Division of General Surgery, Department of Surgery, University of Toronto, Stewart Building, 149 College St., 5th Floor, Toronto, Ontario, M5T 1P5, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St., Toronto, Ontario, M5T 3M6, Canada; Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5, Canada. Electronic address: natalie.coburn@sunnybrook.ca.
Abstract
AIM: Breast cancer and its treatment are associated with varying symptoms. The province of Ontario (13.6 million) has implemented a provincial programme to screen for symptoms among cancer patients using the Edmonton Symptom Assessment System (ESAS). The purpose of this study was to describe symptom burden in the year after diagnosis among women with breast cancer. METHODS: This observational study linked cancer incidence, stage, treatment and demographic data with ESAS scores collected at cancer clinic visits. The cohort consisted of all adult women diagnosed with stage I-III breast cancer between 2007 and 2013 who received surgery as their primary treatment and had at least one symptom screening record. The prevalence and trajectory of moderate-to-severe and severe symptom scores in the year after diagnosis were described. Multivariable logistic regression models identified factors associated with moderate-to-severe and severe symptom scores. RESULTS: The cohort included 23,840 breast cancer patients and with 90,556 unique symptom assessments, within the first year from diagnosis. Tiredness had the highest incidence of moderate-to-severe scores; 60% reported at least one moderate-to-severe score in the 12 months after diagnosis, followed by impaired well-being (53%) and anxiety (44%). Elevated symptom scores were most commonly reported in 6 months after diagnosis. Higher comorbidity score (Aggregated Diagnosis Group ≥10), more advanced stage at diagnosis, younger age, urban residence, lower income and treatment course were associated with moderate-to-severe and severe symptom scores. CONCLUSION: These findings identify time points and patient subgroups at risk for elevated symptom scores and may benefit from personalised or targeted supportive care interventions.
AIM: Breast cancer and its treatment are associated with varying symptoms. The province of Ontario (13.6 million) has implemented a provincial programme to screen for symptoms among cancerpatients using the Edmonton Symptom Assessment System (ESAS). The purpose of this study was to describe symptom burden in the year after diagnosis among women with breast cancer. METHODS: This observational study linked cancer incidence, stage, treatment and demographic data with ESAS scores collected at cancer clinic visits. The cohort consisted of all adult women diagnosed with stage I-III breast cancer between 2007 and 2013 who received surgery as their primary treatment and had at least one symptom screening record. The prevalence and trajectory of moderate-to-severe and severe symptom scores in the year after diagnosis were described. Multivariable logistic regression models identified factors associated with moderate-to-severe and severe symptom scores. RESULTS: The cohort included 23,840 breast cancerpatients and with 90,556 unique symptom assessments, within the first year from diagnosis. Tiredness had the highest incidence of moderate-to-severe scores; 60% reported at least one moderate-to-severe score in the 12 months after diagnosis, followed by impaired well-being (53%) and anxiety (44%). Elevated symptom scores were most commonly reported in 6 months after diagnosis. Higher comorbidity score (Aggregated Diagnosis Group ≥10), more advanced stage at diagnosis, younger age, urban residence, lower income and treatment course were associated with moderate-to-severe and severe symptom scores. CONCLUSION: These findings identify time points and patient subgroups at risk for elevated symptom scores and may benefit from personalised or targeted supportive care interventions.
Authors: AnnaLynn M Williams; Carly Paterson Khan; Charles E Heckler; Debra L Barton; Mary Ontko; Jodi Geer; Amber S Kleckner; Shaker Dakhil; Jerry Mitchell; Karen M Mustian; Luke J Peppone; Victor Kipnis; Charles S Kamen; Ann M O'Mara; Michelle C Janelsins Journal: Breast Cancer Res Treat Date: 2021-01-04 Impact factor: 4.872
Authors: Elizabeth J Siembida; Ashley Wilder Smith; Arnold L Potosky; Kristi D Graves; Roxanne E Jensen Journal: Qual Life Res Date: 2021-01-14 Impact factor: 3.440
Authors: Lev D Bubis; Victoria Delibasic; Laura E Davis; Yunni Jeong; Kelvin Chan; Ekaterina Kosyachkova; Alyson Mahar; Paul Karanicolas; Natalie G Coburn Journal: Support Care Cancer Date: 2020-05-15 Impact factor: 3.603