Evidence map›Paper›PMID 39138736›Full record

ArticleInternational journal of colorectal disease2024

Association between gastrointestinal symptoms and specialty care utilization among colon cancer survivors: a cohort study.

Anya L Edwards, Karen Trang, Irina V Tolstykh, Erin L Van Blarigan, Katherine Van Loon, Angela Laffan, Dalila Stanfield, Paige Steiding, John Neuhaus, Chloe E Atreya and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of colorectal disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Anya L EdwardsDepartment of Surgery, University of California, San Francisco, San Francisco, CA, USA.
Karen TrangDepartment of Surgery, University of California, San Francisco, San Francisco, CA, USA.
Irina V TolstykhDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Erin L Van BlariganDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Katherine Van LoonDivision of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Angela LaffanHelen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
Dalila StanfieldHelen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
Paige SteidingHelen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
John NeuhausDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Chloe E AtreyaDivision of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Sorbarikor PiawahDivision of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Alan P VenookDivision of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Madhulika G VarmaDepartment of Surgery, University of California, San Francisco, San Francisco, CA, USA. mika.varma@ucsf.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePersistent gastrointestinal (GI) symptoms are frequently experienced by colon cancer survivors and may help identify patients with higher utilization of healthcare services. To assess the relationship between GI symptoms and specialty care utilization among colon cancer survivors.

methodsA prospective longitudinal cohort study at an academic medical center of 126 adults surgically treated for stage I-IV colon cancer between February 2017 and June 2022. Participants reported GI symptoms through the EORTC QLQ-C30 and QLQ-CR29 at enrollment and as frequently as every 6 months for 5 years. Main outcome measures were visits, telephone encounters, and secure messages with a medical provider within specialty oncology clinics within 6 months after each survey completion. Generalized linear mixed regression model for repeated measurements with random trajectory for each participant was performed to estimate the associations between symptoms and healthcare use. Models were adjusted for demographics, clinical and surgical factors, and timing in relation to onset of the COVID-19 pandemic.

resultsIn the 6 months after each survey time point, patients averaged 1.2 visits, 0.5 telephone encounters, and 3.2 patient-initiated messages. In adjusted models, those with any abdominal pain (RR 1.45; p = 0.002), buttock pain (RR 1.30; p = 0.050), or increased stool frequency (RR 1.26; p = 0.046) had more clinic visits in the following 6 months than those without these symptoms. Including these three symptoms in one model revealed that only abdominal pain was statistically significantly associated with increased clinic visits (RR 1.36; p = 0.016). Patients with any blood or mucus in stool (RR 2.46; p = 0.009) had significantly more telephone encounters, and those with any abdominal pain (RR 1.65; p = 0.002) had significantly more patient-initiated messages than those without these symptoms.

conclusionsOur findings identify GI symptoms associated with increased use of oncologic specialty care among colon cancer survivors, with abdominal pain as an important predictor of utilization. IMPLICATIONS FOR CANCER SURVIVORS: Early identification and anticipatory management of colon cancer survivors experiencing abdominal pain may decrease healthcare utilization.

Indexed as

Cancer SurvivorsColonic NeoplasmsPatient Acceptance of Health CareAgedCohort StudiesFemaleGastrointestinal DiseasesHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesColon cancer survivorshipGastrointestinal symptomsHealthcare utilizationQuality of life

Identifiers

PMID39138736
PMCPMC11322428

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.