Characterizing Pain, Fatigue and Distress Symptom Severity and Classes in Symptomatic Early-Onset Colorectal Cancer Patients.
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IntroductionThe incidence of early-onset colorectal cancer (EO-CRC) is steadily rising, although the cause is unclear. CRC patients often experience high symptom burden, including pain, fatigue, and distress, but symptom presentations in EO-CRC patients are poorly understood. The aim of the current study was to characterize baseline symptoms (pain, fatigue, distress) and symptom classes in a sample of symptomatic EO-CRC patients.MethodsAnalysis of cross-sectional baseline data from patients enrolled in a mHealth symptom management randomized controlled trial. Participants were 18-50 years old with a CRC diagnosis (stage I-IV) in the last 3 years and self-reported severity of ≥3/10 on at least 2 symptoms (pain, fatigue, distress). Participants completed measures assessing pain (BPI), fatigue (PROMIS), and distress (BSI). Latent class analysis was used to examine symptom classes and moderating variables [sex, cancer stage, site of disease, treatment in past 7 days, body mass index (BMI), years since diagnosis].ResultsParticipants (N=165, M age=42.2 years (SD=5.7), 53% female, 70% White, 48% Stage IV disease, M time since diagnosis=1 year), on average, endorsed mild pain (M=3.0, SD=2.1), high fatigue (M=55.9, SD=7.1), and moderate distress (M=58.2, SD=8.8). A two-class latent class model was fit. Classes were identified as: low pain, moderate fatigue, moderate distress (Class 1; 60%); moderate pain, high fatigue, high distress (Class 2, 40%). Probability profiles differed by sex and BMI, but not by cancer stage, site of disease (colon; rectum), recent active treatment, or years from diagnosis.ConclusionSymptomatic EO-CRC patients enrolled in a symptom management trial experience elevated fatigue, distress, and to a lesser extent, pain. Symptoms presented in two distinct classes characterized by overall low-moderate and moderate-high symptom burden. Sex-based and BMI differences in class membership exist; findings warrant replication. Findings support developing multi-symptom interventions tailored to the needs of EO-CRC patients.