title: Symptom burden among young adults with breast or colorectal cancer.
abstract: BACKGROUND
  Cancer incidence has increased among young adults (YAs) and survival rates have not improved compared with other age groups. Patient-reported outcomes may enhance our understanding of this vulnerable population.
  
  
  METHODS
  In a multisite prospective study, patients completed a cancer symptom inventory at the time of enrollment (T1) and 4 weeks to 5 weeks later (T2). YAs (those aged ≤ 39 years) with breast or colorectal cancer were compared with older adults (those aged ≥ 40 years) with breast or colorectal cancer with regard to symptom severity, symptom interference, changes over time, and medical care.
  
  
  RESULTS
  Participants included 1544 patients with breast cancer (96 of whom were YAs) and 718 patients with colorectal cancer (37 of whom were YAs). Compared with older adults, YAs with breast cancer were more likely to report moderate/severe drowsiness, hair loss, and symptom interference with relationships at T1. YAs with colorectal cancer were more likely to report moderate/severe pain, fatigue, nausea, distress, drowsiness, shortness of breath, and rash plus interference in general activity, mood, work, relationships, and life enjoyment compared with older adults. Compared with older adults, shortness of breath, appetite, and sore mouth were more likely to improve in YAs with breast cancer; vomiting was less likely to improve in YAs with colorectal cancer. Referrals for supportive care were few, especially among patients with colorectal cancer. YAs with breast cancer were somewhat more likely to be referred to nutrition and psychiatry services than older patients.
  
  
  CONCLUSIONS
  YAs reported symptom severity, symptom interference, and variations over time that were distinct from older patients. Distinctions were found to differ by diagnostic group. These findings enhance the understanding of symptom burden in YAs and inform the development of targeted interventions and future research.
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Stacy D
authors.initials: SD
authors.lastname: Sanford
authors.forename: Fengmin
authors.initials: F
authors.lastname: Zhao
authors.forename: John M
authors.initials: JM
authors.lastname: Salsman
authors.forename: Victor T
authors.initials: VT
authors.lastname: Chang
authors.forename: Lynne I
authors.initials: LI
authors.lastname: Wagner
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009325:Nausea / Q000453:epidemiology / Q000209:etiology; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
keywords: breast cancer; colorectal cancer; prospective study; young adults