The association of diabetes mellitus and routinely collected patient-reported outcomes in patients with cancer. A real-world cohort study

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-10-24 DOI:10.1002/cam4.70246

Dominik J. Ose, Emmanuel Adediran, Bayarmaa Mark, Krista Ocier, William A. Dunson JR, Cindy Turner, Belinda Taylor, Kim Svoboda, Andrew R. Post, Jennifer Leiser, Howard Colman, Cornelia M. Ulrich, Mia Hashibe

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Abstract

Objective

Current studies have indicated that diabetes mellitus (DM) is highly prevalent in patients with cancer, but there is little research on consequences on the well-being of patients during cancer treatment. This analysis evaluates the relationship between DM and patient-reported outcomes (PRO) in patients with cancer, using a large and well-characterized cohort.

Methods

This study utilized the Total Cancer Care protocol at the University of Utah Huntsman Cancer Institute. For this analysis, we integrated data from electronic health records, the Huntsman Cancer Registry, and routinely collected PRO questionnaires. We assessed the association between DM in patients with cancer and PRO scores for anxiety, depression, fatigue, pain interference, and physical function using multiple linear regression and t-tests.

Results

The final cohort comprised 3512 patients with cancer, with a mean age of 57.8 years at cancer diagnosis. Of all patients, 49.1% (n = 1724) were female, with 82.0% (n = 2879) patients reporting PROs at least at one time point. Compared with patients who responded, nonresponders were more often female (p = 0.0035), less frequently non-Hispanic White (p = 0.0058), and had a higher BMI (p = 0.0759). Patients with cancer and diabetes had worse PRO scores for anxiety (p = 0.0003), depression (p < 0.0001), fatigue (p < 0.0001), pain interference (p < 0.0001), and physical function (p < 0.0001) compared to patients with cancer without diabetes. Significant associations between diabetes and PRO scores were observed for anxiety (β ± SE: 1.27 ± 0.48; p = 0.0076), depression (β ± SE: 1.46 ± 0.45; p = 0.0011), fatigue (β ± SE: 2.11 ± 0.52; p < 0.0001), pain interference (β ± SE: 1.42 ± 0.50; p = 0.0046), and physical function (β ± SE: −2.74 ± 0.48; p < 0.0001).

Conclusions

The results of this study suggest that patients with cancer and diabetes may be at greater risk for anxiety, depression, fatigue, higher pain interference, and reduced physical function. Strengthening diabetes management is imperative to address the negative impact of diabetes on PROs. In particular, this may be true for patients with skin, breast, prostate, and kidney cancer.

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癌症患者糖尿病与常规收集的患者报告结果之间的关系。一项真实世界队列研究。

目的：目前的研究表明，糖尿病（DM）在癌症患者中的发病率很高，但有关糖尿病对患者在癌症治疗期间的健康影响的研究却很少。本分析利用一个大型且特征明确的队列，评估了癌症患者中糖尿病与患者报告结果（PRO）之间的关系：本研究采用了犹他大学亨茨曼癌症研究所的全面癌症护理方案。在这项分析中，我们整合了电子健康记录、亨茨曼癌症登记和常规收集的PRO问卷调查数据。我们使用多元线性回归和 t 检验法评估了癌症患者的 DM 与焦虑、抑郁、疲劳、疼痛干扰和身体功能的 PRO 评分之间的关联：最终的研究对象包括 3512 名癌症患者，确诊癌症时的平均年龄为 57.8 岁。在所有患者中，49.1%（n = 1724）为女性，82.0%（n = 2879）的患者至少在一个时间点报告了PROs。与做出反应的患者相比，未做出反应的患者多为女性（p = 0.0035），非西班牙裔白人较少（p = 0.0058），体重指数（BMI）较高（p = 0.0759）。癌症和糖尿病患者的焦虑（p = 0.0003）、抑郁（p 结论：癌症和糖尿病患者的PRO评分较低：本研究结果表明，癌症合并糖尿病患者可能面临更大的焦虑、抑郁、疲劳、疼痛干扰和身体功能下降风险。要解决糖尿病对 PROs 的负面影响，加强糖尿病管理势在必行。尤其是皮肤癌、乳腺癌、前列腺癌和肾癌患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.