Association of Social Determinants with Patient Reported Outcomes in Patients with Cancer

Document Type

Conference Proceeding

Publication Date


Publication Title

Annals Of Surgical Oncology


INTRODUCTION: Patient reported outcome (PRO) scores have been utilized more frequently, but the relationship of PRO scores to determinants of health and social inequities have not been widely studied. Our goal was to determine the association of PRO scores with social determinants at a single institution.

METHODS: All patients with a new cancer diagnosis who completed a PRO survey from 2020 to 2022 were included. The PRO survey recorded scores for depression, fatigue, pain and physical condition ranging from 0 to 100 for each score. Higher depression, fatigue and pain scores indicated more distress. Higher physical condition scores indicated improved functionality. A summative score was calculated by adding scores for depression, fatigue, pain and 100-physical condition. A higher summative score indicated more distress. T-tests were used to compare scores between groups.

RESULTS: A total of 1,090 patients were included. Female and minority patients represented 60.4 percent and 33.9 percent of the cohort respectively. Married patients had better individual and summative PRO scores (married sum score = 208.2 ± 37.7 vs. non-married sum score = 215.2 ± 37.3, p < 0.01). Patients who were able to use the online portal to complete their survey also had better individual and summative scores (208.0 ± 35.6 vs. 226.2 ± 42.8, p < 0.01). A negative correlation was observed between age at diagnosis and physical score, indicating worse functionality (Pearson r = -0.156, p < 0.01). Male patients (56.0 ± 11.1 vs. 54.5 ± 9.9, p = 0.04) and minority patients (56.4 ± 10.4 vs. 54.4 ± 10.4, p = 0.01) had worse pain scores than female and Caucasian patients respectively. Figure 1 shows scores based on primary tumor location. Patients with prostate cancer had the best summative scores (191.1 ± 33.5) while patients with gastrointestinal malignancies had the worst scores (221.5 ± 36.1).

CONCLUSIONS: In our study, married patients and patients able to utilize the online portal had improved summative PRO scores. PRO scores also varied by primary cancer location. The level of social support may act in combination with specific patient/tumor factors to influence PRO scores. These findings present opportunities to address patient support at social and institutional levels.



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