Risk of significant functional impairment across cancer diagnosis and care continuum

Ann Marie Flores*, Mitisha Shah, Katy Bedjeti, Patricia D. Franklin, John Devin Peipert, Sofia F. Garcia, Nicola Lancki, Kimberly A. Webster, Mary O’Connor, David Cella

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The authors examined baseline physical functional (PF) impairment among cancer outpatients in the National Cancer Institute Cancer Moonshot study Northwestern University Improving the Management of Symptoms During and Following Cancer Treatment (NU IMPACT). They hypothesized that PF impairment, measured with the Patient Reported Outcome Measurement Information System–Physical Function (PROMIS-PF) survey, would (1) be common and more prevalent for patients receiving treatment compared with no treatment and (2) differ across tumor types, independent of cancer continuum phase. Methods: Adults who were diagnosed with cancer in NU IMPACT (n = 2273) were sampled, and their PROMIS-PF scores were compared across tumor types and cancer continuum (curative, noncurative, or no treatment), with scores ≤40 indicating moderate–severe impairment. Multivariable logistic regression models were used to evaluate the relation among patient and cancer factors and PF scores using a 95% confidence interval. Results: Forty percent of the surveyed patients reported moderate–severe PF impairment. Patients with melanoma reported the least impairment, and those with lung cancer were 6.5 times more likely to have moderate–severe impairment (95% confidence interval, 2.393–17.769). The noncurative group was 1.5 times more likely to have moderate–severe impairment (95% confidence interval, 1.045–2.145; mean score, 43; p <.001) than the curative (mean score, 6) and no treatment (mean score, 48) groups. One-third of those who reported PF impairment also had significant pain and/or fatigue. Conclusions: A sizeable minority experienced PF impairment across tumor types for which pain and/or fatigue co-occurred, particularly in the noncurative group. The PROMIS-PF survey effectively identified variations in physical function. Future studies will explore how screening for PF impairment can be used to refer patients for appropriate cancer rehabilitation services.

Original languageEnglish (US)
Article numbere35571
Journalcancer
Volume131
Issue number1
DOIs
StatePublished - Jan 1 2025

Funding

This work was supported by the National Cancer Institute/National Institutes of Health (Grants 1UM1CA233035 and 3UM1CA233035-01S1). The National Cancer Institute/National Institutes of Health Cancer Moonshot Improving the Management of Symptoms During and Following Cancer Treatment (IMPACT) Consortium consists of three large-scale symptom management systems deployed through electronic health record platforms that are tested in cluster randomized pragmatic trials. This work was supported by the National Cancer Institute/National Institutes of Health (Grants 1UM1CA233035 and 3UM1CA233035\u201001S1). The National Cancer Institute/National Institutes of Health Cancer Moonshot (IMPACT) Consortium consists of three large\u2010scale symptom management systems deployed through electronic health record platforms that are tested in cluster randomized pragmatic trials. Improving the Management of Symptoms During and Following Cancer Treatment

Keywords

  • cancer pain
  • fatigue
  • patient-reported outcomes
  • physical and functional impairment

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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