A Latent Class Analysis of Nutrition Impact Symptoms in Cancer Survivors

Purpose: Those with a cancer diagnosis report experiencing a wide range of nutrition impact symptoms with prevalence varying by study, group and cancer type. We aimed to identify groups of cancer survivors with specific patterns of nutrition impact symptoms.
Methods: 229 individuals attending oncology day ward and outpatient clinics completed a series of questionnaires and physical measurements. A latent class analysis was performed to identify subgroups based on 13 nutrition impact symptoms taken from the Patient Generated Subjective Global Assessment Short Form. The identified classes were subsequently compared using analysis of variance and chi-square tests, by sociodemographic, clinical and nutritional variables as well as by Global health status (GHS) and five functioning scales determined using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).
Results: Three latent subtypes were identified: (1) Fatigue (n=58, 28%); (2) Low Symptom Burden (n=146, 64%) and (3) High Symptom Burden (n=25, 11%). Those in the High Symptom Burden group were more likely to be female, currently receiving any form of treatment and have consumed less food than usual in the last month compared to those in the Low Symptom Burden group. Those in the Fatigue group were more likely were more likely to have reported consuming less food in the previous month and less likely to have reported their food intake to be unchanged than those in the Low Symptom Burden group. Those who received their diagnosis two years+ ago were most likely to be classed in the Fatigue group. The EORTC-QLQ-C30 functioning and GHS scores were all significantly different between the three nutrition impact symptoms classes (p<0.001)
Conclusion: This is the first study to examine heterogeneity of nutrition impact symptoms in Irish Cancer Survivors. The findings of this work will inform and allow for more individualised nutrition care.