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Julie S Olson

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    P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.15-17 - Lung Cancer Symptom Burden and Quality of Life: Findings from the Cancer Experience Registry (ID 12229)

      12:00 - 13:30  |  Presenting Author(s): Julie S Olson

      • Abstract
      • Slides


      Given earlier diagnosis and personalized treatment, lung cancer (LC) survival rates are increasing. LC can be associated with significant emotional distress, which affects health-seeking behaviors and health care utilization. This study examines LC patients’ quality of life compared to other US population groups and cancer-related correlates of depression and anxiety.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      149 individuals with LC enrolled in the Cancer Support Community’s online Cancer Experience Registry and completed surveys including the Patient-Reported Outcomes Measurement Information System (PROMIS-29v2.0). Using multiple regression analysis, we identify predictors of PROMIS T-scores for depression and anxiety. Independent variables included sociodemographic factors (age, gender, education, race), clinical history (time since diagnosis, relapse, LC type, line of therapy, currently receiving treatment, type of therapies received), and symptom burden (number of comorbidities, physical functioning, fatigue, pain interference). Variables significant in bivariate analysis (p<.05) were included in multivariate models.

      4c3880bb027f159e801041b1021e88e8 Result

      The sample was 66% female, 86% White; mean age 62 years (SD=9), mean time since diagnosis 3 years (SD=5). 14% had SCLC, 86% NSCLC. 76% received chemotherapy, 20% immunotherapy; 53% reported current treatment. 23% experienced a relapse, and 42% were ever metastatic.

      PROMIS scores for LC patients were worse than national averages (95% CI) for anxiety (54.2-57.6), fatigue (55.4-58.8), sleep disturbance (51.6-54.6), physical functioning (39.3-41.9), and social functioning (43.1-46.2). Moreover, LC patients reported worse quality of life (>1SD) than the national average for physical functioning (54% of respondents), fatigue (38%), social functioning (34%), anxiety (36%), pain interference (29%), depression (26%), and sleep disturbance (20%).

      Eight predictors explained 51% of the variance in anxiety (R2=.51, F(8,121)=15.64 p<.001); and, greater anxiety was associated with female gender (semipartial r=.18, p<.01), lesser time since diagnosis (semipartial r=-.19, p<.01), worse self-reported health (semipartial r=-.17, p<.01), greater fatigue (semipartial r=.22, p<.01), and greater pain interference (semipartial r=.24, p<.001).

      Nine predictors explained 51% of the variance in depression (R2 = .51, F(9,119)=13.74, p<.001); and, greater depression was associated with female gender (semipartial r=.17, p<.05), not being treated with immunotherapy (semipartial r=-.18, p<.01), poorer self-reported health (semipartial r=-.14, p<.05), greater fatigue (semipartial r=.25, p<.001) and greater pain interference (semipartial r=.23, p<.01).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Substantial proportions of LC survivors experience worse health-related quality of life compared to the general U.S. population. Symptom burden, especially fatigue and pain interference, was associated with anxiety and depression. These results suggest the need for more comprehensive symptom management efforts throughout survivorship care, including increased access to palliative and supportive care services.


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