Implications of sociodemographic and clinical factors on symptom burden: age-specific survivorship care in the primary central nervous system tumor population

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Abstract Background This analysis aims to provide insight into differences in symptom burden and general health status between young adults (YA; 18-39 years old) and older adults (OA; ≥40 years old) with primary central nervous system tumors (PCNST). Methods Data were retrospectively analyzed from the National Cancer Institute Neuro-Oncology Branch’s Natural History Study (NCT02851706 PI: T.S. Armstrong) to determine differences in patient-reported outcomes (general health status [EQ-5D-3L], symptom burden [MDASI-BT and MDASI-SP], anxiety/depression [PROMIS], and perceived cognition [Neuro-QOL]) and demographic and clinical data using chi-square, one-way ANOVA, and Student’s t-tests. Linear regression with backward elimination determined which characteristics impacted perceived symptom burden and general health status. Results The sample included 271 YA (82% with a primary brain tumor (PBT); median age 31 [range, 18-39]) and 516 OA (88% with a PBT; median age 54 [range, 40-85]). YA were more likely to be single (P<0.001), employed (P<0.001), and make < $50,000 per year (P=0.014). More YA reported pain (P=0.008), nausea (P<0.001), drowsiness (P=0.043), and vomiting (P=0.001) than OA. Among demographic and clinical characteristics, when controlling for age, Karnofsky Performance Scale score (P<0.001) and employment status (P<0.001) were predictors of symptom interference, activity- and mood-related interference in patients with PBTs. Compared to OA with spinal tumors, YA reported more moderate-severe anxiety (P=0.050) and moderate-severe perceived cognitive deficits (P=0.023). Conclusions Significant differences in characteristics and symptom burden exist between YA and OA. Developmentally tailored survivorship programs providing additional psychosocial support and resources to address symptom presentation in YA are needed.