A Latent Class Analysis of Nutrition Impact Symptoms in Cancer Survivors

Purpose: Those with a cancer diagnosis report experiencing a wide range of nutrition impact symptoms with prevalence varying by study, group and cancer type. We aimed to identify groups of cancer survivors with specific patterns of nutrition impact symptoms.Methods: 229 individuals attending oncology day ward and outpatient clinics completed a series of questionnaires and physical measurements. A latent class analysis was performed to identify subgroups based on 13 nutrition impact symptoms taken from the Patient Generated Subjective Global Assessment Short Form. The identified classes were subsequently compared using analysis of variance and chi-square tests, by sociodemographic, clinical and nutritional variables as well as by Global health status (GHS) and five functioning scales determined using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Three latent subtypes were identified: (1) Fatigue (n=58, 28%); (2) Low Symptom Burden (n=146, 64%) and (3) High Symptom Burden (n=25, 11%). Those in the High Symptom Burden group were more likely to be female, currently receiving any form of treatment and have consumed less food than usual in the last month compared to those in the Low Symptom Burden group. Those in the Fatigue group were more likely were more likely to have reported consuming less food in the previous month and less likely to have reported their food intake to be unchanged than those in the Low Symptom Burden group. Those who received their diagnosis two years+ ago were most likely to be classed in the Fatigue group. The EORTC-QLQ-C30 functioning and GHS scores were all significantly different between the three nutrition impact symptoms classes (p&lt;0.001)Conclusion: This is the first study to examine heterogeneity of nutrition impact symptoms in Irish Cancer Survivors. The findings of this work will inform and allow for more individualised nutrition care.<br/

A Latent Profile Analysis of Health-related Quality of Life Domains in Cancer Survivors

PurposeThe aim of this research was to examine heterogeneity of Health-related Quality of Life (HrQOL) in Cancer Survivors (both undergoing and completed treatment) using latent profile analysis and to determine whether these groups differed by demographic and health characteristics.MethodsParticipants(n=229) recruited through an oncology day ward and outpatient department in a local hospital, completed height, weight and handgrip measures as well as the validated patient generated subjective global assessment and EORTC-QLQ-C30 questionnaires. A latent profile analysis was performed to identify subgroups based on HrQOL domain scores. Multinominal Logistic Regression was conducted to determine the relationship between these subgroups and demographic and health characteristics. ResultsThree latent subtypes were identified: (1)high quality of life(n=122, 52.8%); (2)compromised quality of life(n=79, 34.2%) and (3)low quality of life(n=30, 12.99%). All subtypes scored lower for functioning scales (with the exception of the higher quality of life group for physical, role and emotional functioning) and higher for symptom scales then the reference norm population. There were large clinically meaningful differences between the high quality of life group and the low quality of life group for all HrQOL scales. Those in the low quality of life group were slightly younger than those in the high quality of life group(OR = 0.956, p &lt; .05, CI = 0.917– 0.998). Workers were &gt;7 times more likely to be in low quality of life than the high quality of life group. Compared to the high quality of life group, the odds of belonging to the compromised quality of life group decreased significantly by having higher handgrip strength (OR = .955, p &lt; .05, CI = .924 - .988). The odds of belonging to the low quality of life group increased significantly for those with higher number of nutrition impact symptoms (NIS) (OR = 1.375, p &lt; .05, CI = 1.004 – 1.883).ConclusionsThis is the first study to examine heterogeneity of HrQOL using latent profile analysis in Irish Cancer Survivors. In clinical practice understanding how aspects of HrQOL group together may allow clinicians to better understand and treat cancer survivors, informing more individualised nutrition care.<br/