Due to aging, older adults with cancer (OAC) may be confronted with a complex interplay of multiple age-related issues; coupled with receiving cancer treatment, OAC may experience multiple concurrent symptoms that require the identification of the core symptom for effective management. Constructing symptom networks will help in the identification of core symptoms and help achieve personalized and precise interventions. Currently, few studies have used symptom networks to identify core symptoms in OAC. Our objectives were to construct symptom networks of OAC, explore the core symptoms, and compare the differences in symptom networks among various subgroups. Secondary analysis was performed using data from 485 OAC collected in 2021 from a cross-sectional survey named the Shanghai CANcer Survivor (SCANS) Report. The MD Anderson Symptom Inventory (MDASI) was used to assess the incidence and severity of cancer-related symptoms. We used the R package to construct symptom networks and identify the centrality indices. The network comparison test was used to compare network differences among the subgroups. The most common and severe symptoms reported were fatigue, disturbed sleep, and difficulty remembering. The network density was 0.718. Vomiting (r = 1.81, r = 2.13), fatigue (r = 1.54, r = 1.93), and sadness (r = 0.81, r = 0.69) showed the highest strength values, which suggested that these symptoms were more likely to co-occur with other symptoms. The network comparison tests showed significant differences in symptom network density between the subgroups categorized as survival “< 5 years” and survival “≥ 5 years” ( = 0.002), as well as between the those with comorbidities and those without comorbidities ( = 0.037). Our study identified symptom networks in 485 OAC. Vomiting, fatigue, and sadness were important symptoms in the symptom networks of OAC. The symptom networks differed among populations with different survival durations and comorbidities. Our network analysis provides a reference for future targeted symptom management and interventions in OAC. In the future, conducting dynamic research on symptom networks will be crucial to explore interaction mechanisms and change trends between symptoms.

中文翻译：

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老年癌症患者的症状网络：网络分析

由于衰老，患有癌症的老年人（OAC）可能面临多种与年龄相关的问题的复杂相互作用；再加上接受癌症治疗，OAC 可能会出现多种并发症状，需要识别核心症状才能进行有效治疗。构建症状网络有助于识别核心症状，有助于实现个性化、精准干预。目前，很少有研究利用症状网络来识别 OAC 的核心症状。我们的目标是构建 OAC 的症状网络，探索核心症状，并比较各个亚组之间症状网络的差异。使用 2021 年一项名为“上海癌症幸存者 (SCANS) 报告”的横断面调查收集的 485 名 OAC 数据进行了二次分析。 MD 安德森症状量表 (MDASI) 用于评估癌症相关症状的发生率和严重程度。我们使用 R 包构建症状网络并确定中心性指数。网络比较测试用于比较亚组之间的网络差异。最常见和最严重的症状是疲劳、睡眠不安和记忆困难。网络密度为0.718。呕吐（r = 1.81，r = 2.13）、疲劳（r = 1.54，r = 1.93）和悲伤（r = 0.81，r = 0.69）显示出最高的强度值，这表明这些症状更有可能同时发生。与其他症状同时发生。网络比较测试显示，生存“< 5年”和生存“≥ 5年”亚组之间（= 0.002）以及有合并症和无合并症的亚组之间的症状网络密度存在显着差异（= 0.037） 。我们的研究确定了 485 个 OAC 的症状网络。呕吐、疲劳和悲伤是 OAC 症状网络中的重要症状。具有不同生存期和合并症的人群之间的症状网络有所不同。我们的网络分析为未来针对 OAC 的症状管理和干预提供了参考。未来，对症状网络进行动态研究对于探索症状之间的相互作用机制和变化趋势至关重要。