Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Prevalence of concurrent severe self-reported late symptoms and functional limitations in cancer survivors: a cross-sectional study of sociodemographic, clinical, and lifestyle associations (126210)

Trille Kjaer 1 , Anne Katrine Levinsen 1 , Erik Jakobsen 2 , Ismail Gögenur 3 , Michael Borre 4 , Peer Christiansen 5 , Robert Zachariae 5 , Peter Christensen 6 , Peter de Nully Brown 7 , Lisbet R Hölmich 8 , Christoffer Johansen 9 , Susanne K Kjær 1 , Lonneke van de Poll-Franse 10 , Susanne O Dalton 1
  1. Danish Cancer Institute, Copenhagen, Denmark
  2. Department of Thoracic surgery, Odense University hospital, Odense
  3. Dept. Surgery, Center for Surgical Science, Zealand University Hospital, Køge
  4. Department of Urology, Aarhus University Hospital, Århus
  5. Danish Breast Cancer Group Center and Clinic for Late Effects, Århus
  6. Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Århus
  7. Department of Hematology, Rigshospitalet, Copenhagen
  8. Department of Plastic Surgery, Copenhagen University Hospital, Herlev
  9. Cancer late effects, Rigshospitalet, Copenhagen
  10. Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam

Background: Despite advances in cancer treatment, survivors often experience persistent symptoms years after diagnosis. This population-based study investigated the prevalence and concurrence of severe symptoms and functional limitations among Danish cancer survivors, and examined associations with sociodemographic, clinical, and lifestyle factors.

Material and methods: We conducted a cross-sectional analysis applying data from the nationwide and population-based SEQUEL questionnaire study (2022), including 40,766 2–12-year cancer survivors, diagnosed between 2010-2019. Twenty-one symptoms, five functioning domains, and one measure of sexual satisfaction were assessed using validated instruments (EORTC QLQ-C30, EORTC Item Library, QLQ-SHQ22, GAD-7, PHQ-9). Sociodemographic, clinical, and lifestyle data were obtained from Danish registries and self-report. To identify severe cases, each symptom and functional limitation were grouped above or below a predefined threshold according to guidelines. Ordinal logistic regression models examined factors associated with concurrent symptoms.

Results: Women reported higher mean number of concurrent symptoms (4.1) than men (3.3), with 25% of women and 16% of men experiencing ≥5 concurrent severe symptoms. Lung cancer survivors reported the highest symptom burden.

Factors significantly associated with increased concurrent symptoms included short education, lower income, living alone, multiple comorbidities (CCI≥2), advanced disease stage, palliative treatment intent, current smoking, and higher BMI among both men and women with ORs ranging from 1.23-2.25 and 1.29-2.19, respectively. Factors associated with impaired functioning paralleled those observed for symptom burden.

Conclusion: Concurrent late symptoms are common among cancer survivors and indicate complex health issues, with patterns varying by cancer type and clinical characteristics and with clear socioeconomic disparity and lifestyle associations.

These findings highlight subgroups who may benefit from various interventions targeting complex multiple symptoms and suggest the importance of addressing social determinants and lifestyle factors in survivorship care.