Sarfraz Azza, Altaf Abdullah, Khalil Mujtaba, Rashid Zayed, Zindani Shahzaib, Mevawalla Areesh, Pawlik Timothy M
Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
J Cancer Surviv. 2025 May 24. doi: 10.1007/s11764-025-01833-1.
The number of gastrointestinal (GI) cancer survivors has increased substantially due to improvements in early detection and treatment, yet long-term functional patient outcomes remain poorly characterized. We sought to quantify the burden of activity limitations (AL) and functional limitations (FL) among GI cancer survivors compared with non-GI cancer survivors and the general U.S. population, as well as identify key predictors of cancer-related limitations.
The National Health Interview Survey (NHIS), a nationally representative dataset (1997-2023), was queried to examine the prevalence and trends of cancer-related limitations among GI cancer survivors, non-GI cancer survivors, and the general U.S.
Multivariable logistic regression analyses identified independent predictors of AL and FL, adjusting for demographic and socioeconomic variables.
Among 5,513 GI cancer and 39,887 non-GI cancer survivors, 50.2% (Relative Risk [RR]: 1.23, 95% CI: 1.19-1.27) and 70.7% (RR: 1.07, 95% CI: 1.05-1.09) of GI cancer survivors reported AL and FL, respectively, compared with non-GI cancer survivors. The general U.S. population had a markedly lower prevalence of AL (13.5%; RR: 0.33, 95% CI: 0.33-0.34) and FL (35.7%; RR: 0.54, 95% CI: 0.53-0.54). GI cancer survivors were older (mean age: 69.1 vs. 65.3 vs. 36.1 years), more often single (8.8% vs. 8.6% vs. 28.3%), and more frequently received public insurance (75.1% vs. 68.9% vs. 27.4%) compared with non-GI cancer survivors and the general population (p < 0.05). In multivariable analysis, GI cancer survivors had 21% higher odds of AL (OR: 1.21, 95% CI: 1.11-1.32, p < 0.001) and 11% higher odds of FL (OR: 1.11, 95% CI: 1.00-1.19, p = 0.049).
GI cancer survivors face a significantly higher burden of functional limitations, influenced by demographic and socioeconomic factors.
Addressing functional disparities through targeted rehabilitation and support services may improve long-term outcomes.
由于早期检测和治疗的改善，胃肠道（GI）癌症幸存者的数量大幅增加，但患者的长期功能结局仍未得到充分描述。我们试图量化GI癌症幸存者与非GI癌症幸存者以及美国普通人群相比的活动受限（AL）和功能受限（FL）负担，并确定癌症相关受限的关键预测因素。
查询具有全国代表性的数据集《国家健康访谈调查》（NHIS，1997 - 2023年），以检查GI癌症幸存者、非GI癌症幸存者和美国普通人群中癌症相关受限的患病率和趋势。
多变量逻辑回归分析确定了AL和FL的独立预测因素，并对人口统计学和社会经济变量进行了调整。
在5513名GI癌症幸存者和39887名非GI癌症幸存者中，分别有50.2%（相对风险[RR]：1.23，95%置信区间[CI]：1.19 - 1.27）和70.7%（RR：1.07，95% CI：1.05 - 1.09）的GI癌症幸存者报告有AL和FL，相比之下非GI癌症幸存者则分别为[对应比例]。美国普通人群的AL患病率（13.5%；RR：0.33，95% CI：0.33 - 0.34）和FL患病率（35.7%；RR：0.54，95% CI：0.53 - 0.54）明显更低。与非GI癌症幸存者和普通人群相比，GI癌症幸存者年龄更大（平均年龄：69.1岁对65.3岁对36.1岁），单身比例更高（8.8%对8.6%对28.3%），接受公共保险的频率更高（75.1%对68.9%对27.4%）（p < 0.05）。在多变量分析中，GI癌症幸存者出现AL的几率高21%（比值比[OR]：1.21，95% CI：1.11 - 1.32，p < 0.001），出现FL的几率高11%（OR：1.11，95% CI：1.00 - 1.19，p = 0.049）。
GI癌症幸存者面临着明显更高的功能受限负担，并受到人口统计学和社会经济因素的影响。
通过有针对性的康复和支持服务解决功能差异问题，可能会改善长期结局。
