title: The importance of symptom surveillance during follow-up care of leukemia, bladder, and colorectal cancer survivors.
abstract: OBJECTIVE
  We examined cancer survivors' experience of bothersome symptoms, association of symptom bother with health-related quality of life (HRQOL), survivors' perception of symptom care, and their symptom-related information needs.
  
  
  METHODS
  Using self-report survey measures, survivors of leukemia, bladder, or colorectal cancer who were 2-5 years post-diagnosis and received follow-up care in the past year (N = 623) provided information about the presence of bothersome symptoms, symptom-related information needs, adequacy of symptom-related care, and their physical and mental HRQOL. Multivariable statistical analyses were conducted to identify correlates of symptom bother, inadequate care, and symptom information needs and to examine the association between symptom bother and HRQOL.
  
  
  RESULTS
  Twenty-eight percent of the 606 respondents experienced symptom bother in the past year (46 % of leukemia, 24 % of bladder, and 26 % of colorectal cancer survivors). Younger survivors, those of Hispanic ethnicity, with low income, those with recurrent cancer, and chemotherapy recipients were more likely to report symptom bother (all p < 0.05). Symptom bother was associated with lower physical and mental HRQOL (p < 0.001). While 92 % of survivors with symptoms discussed them with their follow-up care physician, 52 % of these reported receiving inadequate symptom care. Survivors reporting inadequate symptom care were 2.5 times as likely to identify symptom information needs compared to those who received adequate care (p < 0.05).
  
  
  CONCLUSIONS
  One in four cancer survivors report symptoms 2-5 years post-diagnosis, and only half of these survivors receive adequate care to address those symptoms. Research that refines and tests symptom care interventions for this population is warranted.
authors.affiliation: Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Science, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA, erin.kent@nih.gov.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Kent
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Mitchell
authors.forename: Ingrid
authors.initials: I
authors.lastname: Oakley-Girvan
authors.forename: Neeraj K
authors.initials: NK
authors.lastname: Arora
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007938:Leukemia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D057566:Self Report; D017741:Survivors; D063189:Symptom Assessment / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology
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