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Prevalence of concurrent severe self-reported late symptoms and functional limitations in cancer survivors: a cross-sectional study of sociodemographic, clinical, and lifestyle associations.

Trille Kristina Kjaer ,
Anne Katrine Graudal Levinsen ,
Erik Jakobsen ,
Ismail Gögenur ,
Michael Borre ,
Peer Christiansen ,
Robert Zachariae ,
Peter Christensen ,
Peter de Nully Brown ,
Lisbet Rosenkrantz Hölmich ,
Christoffer Johansen ,
Susanne Krüger Kjær ,
Lonneke van de Poll-Franse ,
Susanne Oksbjerg Dalton

Abstract

METHODS

We conducted a cross-sectional analysis using data from the nationwide SEQUEL questionnaire study (2022), including 40,766 survivors 2- to 12-year post-diagnosis (2010-2019). Up to 21 symptoms, five functioning domains, and sexual satisfaction were assessed using validated instruments (EORTC QLQ-C30, EORTC Item Library, QLQ-SHQ22, GAD-7, PHQ-9). Data were obtained from Danish registries, clinical databases, and self-report. Symptoms and functional limitations were categorized as severe using predefined thresholds. Ordinal logistic regression models examined factors associated with concurrent symptoms.

CONCLUSION

Concurrent late symptoms are common among cancer survivors, indicating complex health issues varying by cancer type and clinical characteristics, with clear socioeconomic disparities and lifestyle associations. These findings highlight subgroups who may benefit from interventions targeting multiple symptoms and underscore the importance of addressing social determinants and lifestyle factors in survivorship care.

RESULTS

Mean symptom count was 4.1 for women (range 0-21, SD 3.19) and 3.3 for men (range 0-20, SD 2.72), with 25% of women and 16% of men experiencing ≥ 5 concurrent severe symptoms. Lung cancer survivors reported the highest symptom burden. Factors significantly associated with concurrent symptoms included short education, lower income, living alone, multiple comorbidities (CCI ≥ 2), advanced disease, palliative treatment, current smoking, and higher BMI, with ORs ranging from 1.29-2.19 (women) and 1.23-2.25 (men). Impaired functioning showed similar associations.

PURPOSE

This population-based study investigated the prevalence of concurrent severe symptoms and functional limitations among Danish cancer survivors, examining associations with sociodemographic, clinical, and lifestyle factors.

More about this publication

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

Volume 34
Issue nr. 3
Publication date 28-02-2026

Full text links

Publisher website (DOI) 10.1007/s00520-026-10482-8
Europe PubMed Central 41762307
Pubmed 41762307

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