Abstract
Purpose
To identify the symptom cluster among cancer survivors and examine their subgroup differences via network analysis based on nationally representative data.
Methods
This cross-sectional study included 2966 survivors participating in the 2020 National Health Interview Survey (NHIS). Participants self-reported the presence of 14 symptoms capturing four clusters (physical, somatic, sleep, and psychologic problems). Network analysis models were used to reveal the relationships between symptoms and those interactions. Network comparison tests were applied to compare subgroups.
Results
The core symptoms of the symptom cluster were fatigue (Bet = 33, Clo = 0.0067, Str = 0.9397), pain (Bet = 11, Clo = 0.0060, Str = 0.9226), wake up well rested (Bet = 25, Clo = 0.0057, Str = 0.8491), and anxiety (Bet = 5, Clo = 0.0043, Str = 0.9697) among cancer survivors. The core symptoms, network structure, and global strength were invariant between time since diagnoses (< 2 years vs. ≥ 2 years) or between numbers of cancers (1 vs. ≥ 2), yet varied between the comorbidity group and non-comorbidity group (≥ 1 vs. 0).
Conclusions
Fatigue would be a potential target for alleviating other symptoms through a negative feedback loop of other related symptoms of cancer survivors. In particular, cancer survivors with other chronic diseases should be the focus of attention and strengthen targeted intervention.
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Data availability
No datasets were generated or analysed during the current study.
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Zhen Zhang and Jiahui Lao. The first draft of the manuscript was written by Zhen Zhang. Supervision and writing—review and editing were performed by Min Zhang, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The National Health Interview Survey (NHIS) is publicly available. The data we used were collected by the National Center for Health Statistics (NCHS). The NHIS protocols were authorized by the NCHS ethics review board. So, the ethical approval was not required.
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All survey participants provided informed consent to participate in NHIS.
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Zhang, Z., Lao, J., Liu, M. et al. Symptom cluster among cancer survivors from a nationally representative survey: a network analysis. Support Care Cancer 32, 333 (2024). https://doi.org/10.1007/s00520-024-08531-1
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DOI: https://doi.org/10.1007/s00520-024-08531-1