The prevalence and risk of symptom and function clusters in colorectal cancer survivors
Purpose Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors. Methods We used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to as...
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| Vydáno v: | Journal of cancer survivorship Ročník 16; číslo 6; s. 1449 - 1460 |
|---|---|
| Hlavní autoři: | , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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New York
Springer US
01.12.2022
Springer Nature B.V |
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| ISSN: | 1932-2259, 1932-2267, 1932-2267 |
| On-line přístup: | Získat plný text |
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| Abstract | Purpose
Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.
Methods
We used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors.
Results
Factor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (
r
= 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors
more
likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors
less
likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality.
Conclusion
Nearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function.
Implications for Cancer Survivors
Improving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors’ HRQOL. |
|---|---|
| AbstractList | Purpose
Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.
Methods
We used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors.
Results
Factor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (
r
= 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors
more
likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors
less
likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality.
Conclusion
Nearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function.
Implications for Cancer Survivors
Improving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors’ HRQOL. Abstract PurposeOur purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.MethodsWe used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors.ResultsFactor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (r = 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors more likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors less likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality.ConclusionNearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function.Implications for Cancer SurvivorsImproving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors’ HRQOL. Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors. We used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors. Factor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (r = 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors more likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors less likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality. Nearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function. Improving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors' HRQOL. Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.PURPOSEOur purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.We used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors.METHODSWe used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors.Factor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (r = 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors more likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors less likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality.RESULTSFactor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (r = 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors more likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors less likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality.Nearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function.CONCLUSIONNearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function.Improving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors' HRQOL.IMPLICATIONS FOR CANCER SURVIVORSImproving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors' HRQOL. |
| Author | Keegan, Theresa H. M. Paddock, Lisa E. Pan, Wei Reeve, Bryce B. Ferguson, Kristin M. Ahn, Jaeil Cress, Rosemary Lin, Li Wu, Xiao-Cheng Potosky, Arnold L. Graves, Kristi D. Fall-Dickson, Jane M. |
| AuthorAffiliation | 4 Department of Professional Nursing Practice, School of Nursing & Health Studies, Georgetown University Medical Center, Washington, DC 20057, USA 11 Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA 5 Department of Biostatistics, Bioinformatics and Biomathematics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA 9 Sciences Center School of Public Health, Louisiana Tumor Registry, Louisiana State University Health, New Orleans, LA 70112, USA 6 MedStar Georgetown University Hospital, Washington, DC 20007, USA 3 Department of Population Health Sciences, Duke University School of Nursing, Duke University School of Medicine, Durham, NC 27701, USA 7 Division of Hematology and Oncology, Department of Internal Medicine, University of California-Davis Comprehensive Cancer Center, Sacramento, CA 95817, USA 2 Department of Population Health Sciences, Center for Health Measurement, Duke University School of Medicine, Durham, NC 27701, |
| AuthorAffiliation_xml | – name: 9 Sciences Center School of Public Health, Louisiana Tumor Registry, Louisiana State University Health, New Orleans, LA 70112, USA – name: 1 Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 2115 Wisconsin Ave NW, Suite 300, Washington, DC 20007, USA – name: 3 Department of Population Health Sciences, Duke University School of Nursing, Duke University School of Medicine, Durham, NC 27701, USA – name: 11 Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA – name: 8 Rutgers School of Public Health and Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA – name: 6 MedStar Georgetown University Hospital, Washington, DC 20007, USA – name: 4 Department of Professional Nursing Practice, School of Nursing & Health Studies, Georgetown University Medical Center, Washington, DC 20057, USA – name: 2 Department of Population Health Sciences, Center for Health Measurement, Duke University School of Medicine, Durham, NC 27701, USA – name: 10 Public Health Institute, Cancer Registry of Greater California, Sacramento, CA, USA – name: 7 Division of Hematology and Oncology, Department of Internal Medicine, University of California-Davis Comprehensive Cancer Center, Sacramento, CA 95817, USA – name: 5 Department of Biostatistics, Bioinformatics and Biomathematics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34787775$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021. |
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| Keywords | Cancer survivors Colorectal neoplasms Symptom assessment Quality of life Population health |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Author contribution ALP was responsible for funding acquisition, supervision, project administration, data curation, and the original draft; BBR and LL were responsible for formal analysis; BBR, LL, and WP were responsible for methodology; all authors contributed to study conceptualization, and review and editing. |
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ThomasBCWallerAMalhiRLFungTCarlsonLEGroffSLA longitudinal analysis of symptom clusters in cancer patients and their sociodemographic predictorsJ Pain Symptom Manage20144756657810.1016/j.jpainsymman.2013.04.00724035068 Buckner TW, Wang J, DeWalt DA, Jacobs S, Reeve BB, Hinds PS. Patterns of symptoms and functional impairments in children with cancer. Pediatric blood & cancer. Wiley Online Library; 2014;61:1282–8. https://doi.org/10.1002/pbc.25029. Laghousi D, Jafari E, Nikbakht H, Nasiri B, Shamshirgaran M, Aminisani N. Gender differences in health-related quality of life among patients with colorectal cancer. Journal of Gastrointestinal Oncology. AME Publications; 2019;10:453. https://doi.org/10.21037/jgo.2019.02.04. JensenREPotoskyALReeveBBHahnECellaDFriesJValidation of the PROMIS physical function measures in a diverse US population-based cohort of cancer patientsQual Life Res2015242333234410.1007/s11136-015-0992-9259353535079641 JeffordMWardACLisyKLaceyKEmeryJDGlaserAWPatient-reported outcomes in cancer survivors: a population-wide cross-sectional studySupport Care Cancer2017253171317910.1007/s00520-017-3725-528434095 Jensen RE, Moinpour CM, Keegan THM, Cress RD, Wu X-C, Paddock LE, et al. The Measuring Your Health Study: leveraging community-based cancer registry recruitment to establish a large, diverse cohort of cancer survivors for analyses of measurement equivalence and validity of the Patient Reported Outcomes Measurement Information System® (PROMIS®) short form items. Psychological Test and Assessment Modeling [Internet]. 2016 [cited 2020 Oct 19];58. 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Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Measuring spiritual well-being in people with cancer: The functional assessment of chronic illness therapy—spiritual well-being scale (FACIT-Sp). Ann Behav Med. 2002;24:49–58. Koch L, Bertram H, Eberle A, Holleczek B, Schmid-Höpfner S, Waldmann A, et al. Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the cancer survivorship--a multi-regional population-based study. Psychooncology. England; 2014;23:547–54. https://doi.org/10.1002/pon.3452. Reeve BB, Pinheiro LC, Jensen RE, Teresi JA, Potosky AL, McFatrich MK, et al. Psychometric evaluation of the PROMIS® fatigue measure in an ethnically and racially diverse population-based sample of cancer patients. Psychological Test and Assessment Modeling. PABST Science Publishers; 2016;58:119. TeresiJAOcepek-WeliksonKCookKFKleinmanMRamirezMReidMCMeasurement equivalence of the Patient Reported Outcomes Measurement Information System® (PROMIS®) pain interference short form items: application to ethnically diverse cancer and palliative care populationsPsychol Test Assess Model201658309352289834495625836 Patient Satisfaction Questionnaires (PSQ-III and PSQ-18) [Internet]. Patient Satisfaction Questionnaire from RAND Health Care | RAND. [cited 2021 Mar 26]. Available from: https://www.rand.org/health-care/surveys_tools/psq.html HubertyCJLowmanLLGroup overlap as a basis for effect sizeEduc Psychol Measur20006054356310.1177/0013164400604004 MazorMCataldoJKLeeKDhruvaACooperBPaulSMDifferences in symptom clusters before and twelve months after breast cancer surgeryEur J Oncol Nurs201832637210.1016/j.ejon.2017.12.00329353634 SmithAWReeveBBBellizziKMHarlanLCKlabundeCNAmsellemMCancer, comorbidities, and health-related quality of life of older adultsHealth Care Financ Rev2008294156187736133142673 Miaskowski C, Cooper BA, Melisko M, Chen L-M, Mastick J, West C, et al. Disease and treatment characteristics do not predict symptom occurrence profiles in oncology outpatients receiving chemotherapy. Cancer. Wiley Online Library; 2014;120:2371–8. KluetzPGSlagleAPapadopoulosEJJohnsonLLDonoghueMKwitkowskiVEFocusing on core patient-reported outcomes in cancer clinical trials: symptomatic adverse events, physical function, and disease-related symptomsClinical Cancer Research AACR201622155315581:CAS:528:DC%2BC28Xls1Kjs7s%3D10.1158/1078-0432.CCR-15-2035 Miaskowski C, Dunn L, Ritchie C, Paul SM, Cooper B, Aouizerat BE, et al. Latent class analysis reveals distinct subgroups of patients based on symptom occurrence and demographic and clinical characteristics. Journal of pain and symptom management. Elsevier; 2015;50:28–37. Lee L, Ross A, Griffith K, Jensen R, Wallen G. Symptom clusters in breast cancer survivors: a latent class profile analysis. Onc Nurs Forum. 2020;47:89–100. https://doi.org/10.1188/20.ONF.89-100. IlliJMiaskowskiCCooperBLevineJDDunnLWestCAssociation between pro- and anti-inflammatory cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depressionCytokine2012584374471:CAS:528:DC%2BC38XksFehtLg%3D10.1016/j.cyto.2012.02.015224502243340525 YostKJEtonDTGarciaSFCellaDMinimally important differences were estimated for six Patient-Reported Outcomes Measurement Information System-Cancer scales in advanced-stage cancer patientsJ Clin Epidemiol20116450751610.1016/j.jclinepi.2010.11.018214474273076200 SalsmanJMYostKJWestDWCellaDSpiritual well-being and health-related quality of life in colorectal cancer: a multi-site examination of the role of personal meaningSupport Care Cancer20111975776410.1007/s00520-010-0871-420405147 MatiasMBaciarelloGNejiMDi MeglioAMichielsSPartridgeAHFatigue and physical activity in cancer survivors: a cross-sectional population-based studyCancer Med201982535254410.1002/cam4.2060308643016536944 KwekkeboomKLAbbott-AndersonKCherwinCRoilandRSerlinRCWardSEPilot randomized controlled trial of a patient-controlled cognitive-behavioral intervention for the pain, fatigue, and sleep disturbance symptom cluster in cancerJ Pain Symptom Manage20124481082210.1016/j.jpainsymman.2011.12.281227711253484234 Qaderi SM, Ezendam NP, Verhoeven RH, Custers JA, de Wilt JH, Mols F. Follow‐up practice and healthcare utilisation of colorectal cancer survivors. European Journal of Cancer Care. Wiley Online Library; 2021;e13472. https://doi.org/10.1111/ecc.13472. BredleJMSalsmanJMDebbSMArnoldBJCellaDSpiritual well-being as a component of health-related quality of life: the functional assessment of chronic illness therapy—spiritual well-being scale (FACIT-Sp)Religions Molecular Diversity Preservation International20112779410.3390/rel2010077 ThavarajahNChenEZengLBedardGDi GiovanniJLemkeMSymptom clusters in patients with metastatic cancer: a literature reviewExpert Rev Pharmacoecon Outcomes Res20121259760410.1586/erp.12.4123186400 Adams SV, Ceballos R, Newcomb PA. Quality of life and mortality of long-term colorectal cancer survivors in the Seattle Colorectal Cancer Family Registry. Montazeri A, editor. PLoS ONE. 2016;11:e0156534. https://doi.org/10.1371/journal.pone.0156534. CellaDChoiSGarciaSCookKFRosenbloomSLaiJ-SSetting standards for severity of common symptoms in oncology using the PROMIS item banks and expert judgmentQual Life Res2014232651266110.1007/s11136-014-0732-6249384314710358 ShiQSmithTGMichonskiJDSteinKDKawCCleelandCSSymptom burden in cancer survivors 1 year after diagnosis: a report from the American Cancer Society’s Studies of Cancer SurvivorsCancer20111172779279010.1002/cncr.2614621495026 Miaskowski C, Barsevick A, Berger A, Casagrande R, Grady PA, Jacobsen P, et al. Advancing symptom science through symptom cluster research: expert panel proceedi PG Kluetz (1123_CR12) 2016; 22 1123_CR20 J Illi (1123_CR4) 2012; 58 1123_CR41 1123_CR40 1123_CR24 1123_CR44 1123_CR21 SC Agasi-Idenburg (1123_CR10) 2017; 25 RA Roiland (1123_CR31) 2011; 38 BC Thomas (1123_CR39) 2014; 47 N Thavarajah (1123_CR23) 2012; 12 AW Smith (1123_CR11) 2008; 29 Q Shi (1123_CR34) 2011; 117 M Jefford (1123_CR6) 2017; 25 1123_CR28 1123_CR27 KJ Yost (1123_CR32) 2011; 64 M Matias (1123_CR8) 2019; 8 1123_CR26 JM Salsman (1123_CR43) 2011; 19 CJ Huberty (1123_CR17) 2000; 60 1123_CR25 M Mazor (1123_CR9) 2018; 32 1123_CR30 JA Teresi (1123_CR46) 2016; 58 1123_CR13 1123_CR35 S Faury (1123_CR7) 2020; 38 P Boedeker (1123_CR16) 2019; 2 JM Bredle (1123_CR22) 2011; 2 A Berger (1123_CR29) 2020; 7 KL Kwekkeboom (1123_CR5) 2012; 44 D Cella (1123_CR33) 2014; 23 RE Jensen (1123_CR45) 2015; 24 1123_CR38 1123_CR15 1123_CR37 JA McDougall (1123_CR42) 2019; 13 1123_CR14 1123_CR36 1123_CR1 1123_CR2 1123_CR3 1123_CR19 1123_CR18 |
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England; 2014;23:547–54. https://doi.org/10.1002/pon.3452. – reference: Miaskowski C, Dunn L, Ritchie C, Paul SM, Cooper B, Aouizerat BE, et al. Latent class analysis reveals distinct subgroups of patients based on symptom occurrence and demographic and clinical characteristics. Journal of pain and symptom management. Elsevier; 2015;50:28–37. – reference: Miaskowski C, Cooper BA, Melisko M, Chen L-M, Mastick J, West C, et al. Disease and treatment characteristics do not predict symptom occurrence profiles in oncology outpatients receiving chemotherapy. Cancer. 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Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.
Methods... Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors. We used data... Abstract PurposeOur purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer... Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.PURPOSEOur... |
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| SubjectTerms | Adult Cancer Cancer Survivors Chemotherapy Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - epidemiology Colorectal Neoplasms - psychology Factor analysis Female Health Informatics Health Promotion and Disease Prevention Humans Medicine Medicine & Public Health Mental disorders Oncology Prevalence Primary Care Medicine Public Health Quality of life Quality of Life - psychology Quality of Life Research Regression analysis Risk factors Survivors - psychology Well being |
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| Title | The prevalence and risk of symptom and function clusters in colorectal cancer survivors |
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