Physical health and function trajectories in adults with cancer: psychosocial predictors of class membership

Keith M Bellizzi; Crystal L Park; Jung Wun Lee; Ofer Harel; Tara Sanft; Emily Fritzson; Caroline Salafia; Kaleigh Ligus; Katherine Gnall; Zachary E Magin

doi:10.1007/s11764-024-01540-3

Physical health and function trajectories in adults with cancer: psychosocial predictors of class membership

J Cancer Surviv. 2024 Jan 30. doi: 10.1007/s11764-024-01540-3. Online ahead of print.

Authors

Affiliations

¹ Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06269, USA. keith.m.bellizzi@uconn.edu.
² Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
³ Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA.
⁴ Department of Statistics, University of Connecticut, Storrs, CT, 06269, USA.
⁵ Department of Medicine (Medical Oncology), Yale School of Medicine, New Haven, CT, 06510, USA.
⁶ Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06269, USA.

PMID: 38289507
DOI: 10.1007/s11764-024-01540-3

Abstract

Purpose: To prospectively examine different trajectories of recovery, across different aspects of physical health and function and to examine trajectory class membership.

Methods: This prospective study enrolled 569 recently diagnosed adult cancer patients (Mage = 58.7) between 2019 and 2022 identified through the Rapid Case Ascertainment resource of The Yale Cancer Center. Patients were diagnosed with breast (63.8%), prostate (25.3%), or colorectal cancer (10.9%) within six-months of baseline assessment. Participants completed comprehensive psychosocial and health survey measures (SF-12) through REDCap at five time points. Growth mixture modeling examined unconditional distinct trajectories for four aspects of physical health and function. We fit logistic regression and multinomial logistic regression models to estimate associations between psychosocial predictors of trajectory class membership for each of the four aspects.

Results: We identified distinct trajectories of physical health and function. Over one-third (38.4%) of the sample experienced low and declining scores in their ability to accomplish work/regular daily activities due to physical health. Over half (54.9%) demonstrate moderately stable general health with no improvement over time. A small but significant subset of the sample (3%, 5.7%, 5%) was in the moderate and declining groups with sharp decline in physical function, bodily pain, and general health, after treatment. Different predictors of trajectory class membership were also found.

Conclusions: Our results showed heterogeneity in physical health and function trajectories and different patterns of predictors for each aspect of physical health and function. Findings have the potential to inform screening and intervention efforts to help those who may need additional support.

Keywords: Adult oncology; Physical health and function; Psychosocial oncology; Risk and resilience; Trajectory modeling.

Grants and funding

NCI (Grant UH3CA220642)./NH/NIH HHS/United States