Assessing the relationship between symptoms and health care utilization in colorectal cancer survivors of different sexual orientations

• Published in: Supportive care in cancer Vol. 29; no. 10; pp. 5821 - 5830
• Main Authors: Boehmer, Ulrike, Potter, Jennifer, Clark, Melissa A., Ozonoff, Al, Winter, Michael, Berklein, Flora, Ward, Kevin C, Hartshorn, Kevan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2021; Springer; Springer Nature B.V
• Subjects: Analysis; Anxiety; Body image; Cancer survivors; Colorectal cancer; Diagnosis; Health; Health care industry; Health services utilization; Medical care; Medicine; Medicine & Public Health; Mental health; Nursing; Nursing Research; Oncology; Original Article; Pain; Pain Medicine; Rehabilitation Medicine; Sexual minorities; Sexual orientation; Surveys; Survivor; Utilization; Weight; Weight control; Oncology; Sexual minorities; Colorectal neoplasms; Patient-reported outcomes; Health services
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-021-06157-1

Objective The purpose of this study was to determine the association of physical and psychological symptoms with health care utilization in sexual minority and heterosexual colorectal cancer survivors. Methods Four hundred eighteen colorectal cancer survivors who were in remission an average of 3 years after their diagnosis were surveyed about their non-emergency health care visits during the preceding 3 months. Survivors reported whether they had experienced any of 21 symptoms common among colorectal cancer survivors in the past week. The relation between having had two or more health care visits in the preceding 3 months and symptoms experienced was assessed using logistic regression, controlling for cancer registry, sexual orientation, sex, age, race/ethnicity, income, and comorbidities. Results Of the survivors, 12% reported no symptoms, while 12% reported six or more symptoms. Sexual minority survivors reported significantly more weight concerns and more health-related and general anxiety as well as worse body image than heterosexual survivors. Frequent worrying about weight and experiencing sore skin around the anal area or stoma were the two symptoms that significantly contributed towards explaining survivors’ increased health care utilization. Conclusion Weight concerns, which are more common among the heaviest survivors, may prompt survivors to seek help from health care providers, which may lead to more frequent visits. On the other hand, some symptoms, despite their prevalence, had no relationship with the frequency of health care visits, raising questions about whether survivors share these concerns with providers.