Contemporaneous symptom networks of multidimensional symptom experiences in cancer survivors: A network analysis

Background Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have explored the symptom networks of multidimensional symptom experiences in cancer survivors. The objectives of this study were to generate symptom networks of multidimensional symptom experiences in cancer survivors and explore the centrality indices and density in these symptom networks Methods Data from 1065 cancer survivors were obtained from the Shanghai CANcer Survivor (SCANS) Report. The MD Anderson Symptom Inventory was used to assess the prevalence and severity of 13 cancer-related symptoms. We constructed contemporaneous networks with all 13 symptoms after controlling for covariates. Results Distress (r(s) = 9.18, r(c) = 0.06), sadness (r(s) = 9.05, r(c) = 0.06), and lack of appetite (r(s) = 9.04, r(c) = 0.06) had the largest values for strength and closeness. The density of the less than 5 years network was significantly different from that of the 5-10 years and over 10 years networks (p < 0.001). We found that while fatigue was the most severe symptom in cancer survivorship, the centrality of fatigue was lower than that of the majority of other symptoms. Conclusion Our study demonstrates the need for the assessment of centrality indices and network density as an essential component of cancer care, especially for survivors with <5 years of survivorship. Future studies are warranted to develop dynamic symptom networks and trajectories of centrality indices in longitudinal data to explore causality among symptoms and markers of interventions.

Automated summary

This study examines symptom networks of multidimensional symptom experiences in cancer survivors, exploring centrality indices and network density. The findings indicate that fatigue is a severe symptom but has lower centrality compared to other symptoms. Additionally, there is a significant difference in network density between survivors with less than 5 years of survivorship and other time periods.