Dhruvin H Hirpara1, Vaibhav Gupta1, Laura E Davis2, Haoyu Zhao3, Julie Hallet4, Alyson L Mahar5, Rinku Sutradhar6, Mark Doherty7, Alexander V Louie8, Biniam Kidane9, Gail Darling10, Natalie G Coburn11. 1. Department of Surgery, University of Toronto, 149 College St., Toronto, ON M5T 1P5, Canada. 2. Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada. 3. ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada. 4. Department of Surgery, University of Toronto, 149 College St., Toronto, ON M5T 1P5, Canada; Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada; ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada. 5. Manitoba Centre for Health Policy, University of Manitoba, 727 McDermot Ave., Winnipeg, MB R3B 3P5, Canada. 6. Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada; ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada. 7. Division of Medical Oncology, University of Toronto, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada. 8. Division of Radiation Oncology, University of Toronto, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada. 9. Section of Thoracic Surgery, University of Manitoba, 820 Sherbrook St., Winnipeg, MB R3A 1R9, Canada. 10. Division of Thoracic Surgery, Toronto General Hospital, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada. 11. Department of Surgery, University of Toronto, 149 College St., Toronto, ON M5T 1P5, Canada; Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada; ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada. Electronic address: natalie.coburn@sunnybrook.ca.
Abstract
OBJECTIVES: Lung cancer is associated with significant disease- and treatment-related morbidity. The Edmonton Symptom Assessment System (ESAS) is a tool developed to elicit patients' own assessment of the severity of common cancer-associated symptoms. The objective of this study was to examine symptom severity in the 12 months following diagnosis of lung cancer, and to identify predictors of high symptom burden. MATERIALS AND METHODS: This was a retrospective population-based cohort study, including patients with stage I-III lung cancer diagnosed between 2007-2016, and who had symptom screening in the 12 months following diagnosis. The proportion of patients reporting severe symptoms (ESAS ≥ 7) in the year following diagnosis was plotted over time. Multivariable regression models were constructed to identify factors associated with severe symptoms. RESULTS: 69,440 unique symptom assessments were reported by 11,075 lung cancer patients. Tiredness was the most prevalent severe symptom (47.3 %), followed by shortness of breath (39.4 %) and poor wellbeing (36.5 %) among all disease stages. Patients diagnosed with higher stage disease reported more severe symptoms, but symptom trajectories were similar for all stages in the year following diagnosis. Disease stage (RR 1.10-2.01), comorbidity burden (RR 1.17-1.51), degree of socioeconomic marginalization (RR1.15-1.45), and female sex (RR 1.15-1.50) were associated with reporting severe symptoms in the year following diagnosis. CONCLUSION: Severe physical and psychological symptoms persist throughout the first year following lung cancer diagnosis, regardless of disease stage. Those at risk of experiencing high symptom burden may benefit from targeted supportive care interventions, including psychosocial support aimed at improving health-related quality of life. Crown
OBJECTIVES:Lung cancer is associated with significant disease- and treatment-related morbidity. The Edmonton Symptom Assessment System (ESAS) is a tool developed to elicit patients' own assessment of the severity of common cancer-associated symptoms. The objective of this study was to examine symptom severity in the 12 months following diagnosis of lung cancer, and to identify predictors of high symptom burden. MATERIALS AND METHODS: This was a retrospective population-based cohort study, including patients with stage I-III lung cancer diagnosed between 2007-2016, and who had symptom screening in the 12 months following diagnosis. The proportion of patients reporting severe symptoms (ESAS ≥ 7) in the year following diagnosis was plotted over time. Multivariable regression models were constructed to identify factors associated with severe symptoms. RESULTS: 69,440 unique symptom assessments were reported by 11,075 lung cancerpatients. Tiredness was the most prevalent severe symptom (47.3 %), followed by shortness of breath (39.4 %) and poor wellbeing (36.5 %) among all disease stages. Patients diagnosed with higher stage disease reported more severe symptoms, but symptom trajectories were similar for all stages in the year following diagnosis. Disease stage (RR 1.10-2.01), comorbidity burden (RR 1.17-1.51), degree of socioeconomic marginalization (RR1.15-1.45), and female sex (RR 1.15-1.50) were associated with reporting severe symptoms in the year following diagnosis. CONCLUSION: Severe physical and psychological symptoms persist throughout the first year following lung cancer diagnosis, regardless of disease stage. Those at risk of experiencing high symptom burden may benefit from targeted supportive care interventions, including psychosocial support aimed at improving health-related quality of life. Crown
Authors: Carolyn J Presley; Nicole A Arrato; Peter G Shields; David P Carbone; Melisa L Wong; Jason Benedict; Sarah A Reisinger; Ling Han; Thomas M Gill; Heather Allore; Barbara L Andersen; Sarah Janse Journal: JTO Clin Res Rep Date: 2022-05-17