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

doi:10.1002/cncr.35571

Risk of significant functional impairment across cancer diagnosis and care continuum

Cancer. 2024 Sep 19. doi: 10.1002/cncr.35571. Online ahead of print.

Authors

Ann Marie Flores^{1

2

3}, Mitisha Shah¹, Katy Bedjeti¹, Patricia D Franklin^{2

4

5}, John Devin Peipert^{2

3}, Sofia F Garcia^{2

3}, Nicola Lancki^{3

6}, Kimberly A Webster², Mary O'Connor², David Cella^{2

3}

Affiliations

¹ Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
² Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
³ Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA.
⁴ Department of Orthopedics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
⁵ Department of Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
⁶ Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

PMID: 39297349
DOI: 10.1002/cncr.35571

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.

Keywords: cancer pain; fatigue; patient‐reported outcomes; physical and functional impairment.

Abstract

Grants and funding