Distinct Symptom Occurrence Subgroups Among Patients With Colorectal Cancer: Differences in Social Determinants of Health and Diet Quality.

This was a secondary cross-sectional analysis, so it cannot show that income, social support, or diet quality caused symptom differences. The sample came from three U.S. centers and was mostly non-Hispanic White, insured, married, and highly educated, so it may not represent more diverse or under-resourced patients. Diet quality data were available for only 137 of the 256 participants. The symptom groups were exploratory latent classes, and the study did not correct for multiple comparisons, so some findings may be false positives. Diet was measured once with a general-population index, not a colorectal-cancer-specific measure, and recall and portion-size bias are possible. Symptom responses were dichotomized into presence or absence, so severity differences within each symptom were not analysed. The study did not measure access to or use of symptom medications, which could influence symptom severity.

The authors declared no conflicts of interest. Funding came from Sigma Theta Tau International, National Cancer Institute, National Institute on Aging, National Institute of Diabetes and Digestive and Kidney Diseases, and National Institute of Nursing Research.

Do not read these associations as evidence that increasing income, social support, or diet quality will reduce symptoms. The study is cross-sectional and exploratory, and it did not test whether changing these factors changes symptoms.