Abstract 4368: Symptom network identification from anxious and depressive groups in colorectal cancer patients
Authors: Sim Jinah , Yu Ji Won , Song Nan , Shin Ae Sun , Park Ji Won , Jeong Seung Yong 
Published: April 2023

Abstract
Backgrounds: Colorectal cancer (CRC) is one of the most common cancers in the world, and recently in South Korea, the incidence rates are increasing. CRC patients have a high prevalence of depression and experience various symptoms such as bowel problems. However, previous studies analyzing network analysis has not yet been conducted to understand the association between symptoms with chronic anxiety and depression.
Methods: In this study, symptom network and centrality analysis were conducted to confirm the interaction between symptoms and functioning (e.g., pain, fatigue, physical functioning, etc.) of patients diagnosed with CRC according to the higher risk of anxiety and depressive groups ahead of surgical treatment. In this study, symptom and functioning variables in a total of 939 CRC patients were measured using EORTC QLQ-C30 and EORTC QLQ-CR29. Network analysis, visualization, and centrality analysis were performed to determine the connectivity between anxiety, depression, and other correlated symptoms amongst CRC patients using the qgraph R package.
Results: As a result of confirming the difference in anxiety and depression according to socio-demographic characteristics, there was a significant difference in the education level in the group with anxiety(Ps&lt;0.05). The group with depression showed significant differences in Fasting blood sugar and education level(Ps&lt;0.05). There were significant differences in symptoms according to anxiety and depression, the group with high risk of anxiety showed significant differences in 30 symptoms such as urological frequency and physical function. The group having depression showed significant differences in 26 symptoms such as fatigue and physical function. In the result of performing symptom network analysis and centrality analysis without any stratification of anxiety or depression, fatigue was found to be a central symptom in all patients. In both the anxious and depressed groups, pain was estimated as the central symptom.
Conclusion: In conclusion, the study compared and analyzed symptom networks to confirm the interaction between symptoms of CRC patients according to anxiety and depression. The symptom network of CRC patients showed different patterns according to anxiety and depression. Pain appeared as a central symptom in both the anxious and depressed groups. This indicates that pain is a key role because it is related to other symptoms and affects the flow of the symptom network the most. Therefore, intensive pain management is expected to be important in treating CRC patients with anxiety and depression. It is expected that the basis for the management of colorectal cancer patients and survivors can be prepared toward the long term of cancer treatment and survival.
Citation Format: Jinah Sim, Ji Won Yu, Nan Song, Ae Sun Shin, Ji Won Park, Seung Yong Jeong. Symptom network identification from anxious and depressive groups in colorectal cancer patients. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4368.