Clinically significant symptoms prevalence in breast and colon cancers and leukemia patients: a comparison analysis of patient-reported outcomes

Purpose To assess the prevalence and severity of clinically significant symptoms (CSSs) for breast cancer, colon cancer, and leukemia patients undergoing chemotherapy. Methods A retrospective review of the Edmonton Symptom Assessment System scores reported by patients from the database of our previous large-scale study, which was collected between May 2018 and January 2019. We described the prevalence of CSSs in proportion and severity in mean +/- SD. Results Of 546 cancer patients, 209 were breast cancer, 159 were colon cancer, and 178 were leukemia. The majority of participants were females 345 (63.2%), and the mean age of the entire study sample was 49.4 +/- 13.93. Diminished feeling of well-being was the most prevalent CSS across the three cancers, with a statistically significant difference (p < 0.001). Fatigue (6.59 +/- 2.07), pain (6.55 +/- 2.01), and loss of appetite were the most distressing CSSs (6.49 +/- 1.99) across the whole sample. Loss of appetite (6.34 +/- 2.05) was the most distressing CSS in breast cancer, fatigue (6.97 +/- 2.07) in leukemia, and pain (7.00 +/- 2.11) in colon cancer. Statistically significant differences were found in the severity between the three cancer in pain (p < 0.001), fatigue (p = 0.010), nausea (p = 0.001), and diminished feeling of well-being (p = 0.033). Cancer type, sleeping hours, dependence on caregiver, female gender, level of education, and employment were significantly associated with higher odds of CSS severity. Conclusion Breast and colon cancer and leukemia patients undergoing chemotherapy experience multiple distressing CSSs. Our study validates CSSs as a discrete set of distressing symptoms that may serve and guide quality of care assessment and cancer clinical research, particularly among patients undergoing chemotherapy.