Symptom prevalence in gastrointestinal cancer: a secondary analysis of IPOS data.

Purpose: Patients with gastro-intestinal (GI) cancer have a high symptom burden; however, comparative data to other cancers is lacking. The aim is to determine symptom prevalence for people with GI cancer receiving specialist palliative care in the community.

Method: Secondary analysis of anonymised routinely collected symptom registry data from those receiving community-based specialist palliative care, between 2020 and 2023.

Results: One thousand seven hundred thirty-three patients with GI cancer received 2,332 episodes of specialist palliative care. Common symptoms were: - pain (77% prevalence in GI cancer vs 73% other cancers); with 49% reporting being moderately/severely/overwhelmingly affected in GI vs 46% in other cancers. - nausea (34% in GI cancer vs 25% other cancers); with 16% moderately/severely/overwhelmingly affected in GI vs 11% in other cancers. - vomiting (17% in GI cancer vs 11% other cancers); with 8% moderately/severely/overwhelmingly affected in GI vs 5% in other cancers. - poor appetite (77% in GI cancer vs 68% other cancers); with 56% moderately/severely/overwhelmingly affected in GI vs 46% in other cancers. poor mobility (79% in GI cancer vs 84% other cancer); with 53% moderately/severely/overwhelmingly affected in GI vs 62% in other cancers.

Conclusion: This novel study provides comparative evidence about the nature of the high symptom burden for those with GI cancer and shows that poor appetite, nausea, vomiting, and worse mobility are more prevalent compared to other cancers, while pain and weakness are of similar prevalence. The underlying reasons may relate to illness trajectory, referral timing, or other causes and need further exploration.