Distinct Symptom Occurrence Subgroups Among Patients With Colorectal Cancer: Differences in Social Determinants of Health and Diet Quality
Year: 2026
Type: article
Abstract: Colorectal cancer (CRC) is a leading cause of cancer mortality in the United States. Many patients with CRC experience physical and psychological symptoms that diminish quality of life and are shaped by social determinants of health (SDOH) and diet quality. This study aimed to (a) identify distinct symptom occurrence subgroups among patients with CRC, and (b) examine differences in SDOH characteristics and diet quality across these symptom occurrence subgroups. We conducted a secondary analysis of the ColoCare Study dataset from the Huntsman Cancer Institute, including CRC patients 6 months postdiagnosis. Latent class analysis identified subgroups based on the presence of symptoms. Chi-square tests and ANOVA examined subgroup differences in SDOH and diet quality, measured by the Healthy Eating Index (HEI)-2020. Logistic regression adjusted for cancer stage, comorbidity status, neoadjuvant or adjuvant therapy. Among 256 patients, three subgroups emerged: low (n = 84), moderate (n = 123), and high symptom occurrence (n = 49). Patients with high symptom occurrence were younger (F = 4.48, p = 0.01), more often Hispanic (χ² = 9.10, p = 0.01), had lower income (χ² = 12.92, p = 0.01), and more frequently received neoadjuvant therapy (χ² = 10.30, p = 0.006). They reported lower total social support (F = 5.60, p = 0.004) and poorer diet quality (F = 9.58, p = 0.0001). After adjustment, high symptom occurrence group had lower odds of adequate income (OR = 0.28, p = 0.0312), social support (OR = 0.886, p = 0.0100), and diet quality (OR = 0.94, p = 0.0156). Distinct CRC symptom profiles highlight the need for personalized dietary interventions and enhanced social support to improve symptom management. PATIENT OR PUBLIC CONTRIBUTION: Findings emphasize care strategies that address SDOH to optimize outcomes and quality of life for patients with CRC.
Source: Research in Nursing & Health
DOI: 10.1002/nur.70083
Authors: Youran Lee, Qing Yang, Melissa Kay, Donald E. Bailey, Biljana Gigic, Sheetal Hardikar, Adetunji T. Toriola, David Shibata, Christopher I. Li, Doratha A. Byrd, Jane C. Figueiredo, Ildiko Strehli, Megan Mclaws, Vaia Florou, Mmadili Ilozumba, Patricia Erickson, Apurva Medhe, Cornelia M. Ulrich, Rosa M. Gonzalez‐Guarda
Institutions: Duke University, University of Michigan, Wake Forest University, University Hospital Heidelberg, Huntsman Cancer Institute, Washington University in St. Louis, Alvin J. Siteman Cancer Center, University of Tennessee Health Science Center, Fred Hutch Cancer Center, Moffitt Cancer Center, Cedars-Sinai Medical Center, University of Utah, University of Kansas
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,150
Awards: Novel Biomarkers for Cancer-Related Fatigue: Integrating Metabolomics, Genomics and Behaviors, G7650952084, University of Utah Interdisciplinary Training Program in Computational Approaches to Diabetes and Metabolism Research, Transdisciplinary Team Science in Colorectal Cancer Prognosis: the ColoCare Study, Geriatric assessment domains in relation to treatment outcomes among older adults with colorectal cancer
OpenAlex ID: W7162399991