Network Analysis of Symptoms and Comorbidity in Patients With Early-Onset Colorectal Cancer: Comparison With Late-Onset Colorectal Cancer
Jiwon Yu, Jae Hyun Park, Young Ho Yun, Nan Song, Aesun Shin, Min Jung Kim, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Rumi Shin, Jin-ah Sim, Ji Won ParkPurpose
Patients with early-onset colorectal cancer (EOCRC) experience various symptoms and comorbidities throughout the treatment continuum. Identifying the intricate relationship between symptoms and comorbidities in EOCRC can provide a deeper understanding of the underlying mechanisms that shape the patient's entire experience. This study aimed to compare the association between symptoms and comorbidities in patients by age of onset to identify key relationships between symptoms and comorbid disease in EOCRC.
Methods
Data of 985 patients enrolled in a prospective colorectal cancer (CRC) cohort between 2013 and 2021 in the Republic of Korea were analyzed. At baseline, patients were assessed for 33 symptoms and functions, as well as 14 comorbidities, and were subsequently stratified into two age groups: <50 (EOCRC) and ≥50 years (late-onset CRC [LOCRC]). Symptoms and comorbidity relationships were examined using correlation-based network analysis.
Results
In total, 13.5% of the participants had EOCRC. In the EOCRC group, 44 patients (33.1%) had existing comorbidities. The symptom and comorbidity networks were more complex in EOCRC than in LOCRC. Fatigue was a central symptom in both age groups. The EOCRC group exhibited positive correlations between musculoskeletal disease and psychiatric disorder, stool frequency, and multiple symptoms. The LOCRC group showed pronounced correlations between embarrassment by bowel movement and multiple symptoms and between health functioning parameters and fatigue.
Conclusion
Cancer-related fatigue was an important feature in both groups. These findings underscore the importance of considering these factors to enhance quality-of-life care outcomes during and after CRC treatment.