FUNCTIONAL OUTCOMES OF INDIVIDUALS WITH CARDIOVASCULAR DISEASE AFTER GASTROINTESTINAL CANCER

Abstract

Background: Gastrointestinal (GI) cancer contributes to 25% of the cancer cases globally. The cancer screening program and advanced treatments lead to an increase in cancer diagnoses at a younger age and improved the survival rate. Yet, the survival might not be disability-free. GI cancer and its treatments may result in ongoing physical, cognitive, and psychological impairments, contributing to a higher risk of functional deficits. However, no studies have prospectively examined the functional abilities of people before and after their GI cancer diagnosis, despite the functional risk. GI cancer is 20 times more commonly diagnosed among people with cardiovascular disease after GI bleeding. Thus, we studied patients with cardiovascular disease and GI bleeding who are at risk of developing GI cancer and examined their change in functional ability before and after their newly diagnosed GI cancer. Materials and Methods: We identified INTERBLEED (The International Study of the Risk Factors for GI Bleeding and Cardiovascular Events after GI Bleeding) participants who were newly diagnosed with GI cancer after study enrolment and completed the Standard Assessment of Global Everyday Activities (SAGEA) pre and post-GI cancer diagnoses. SAGEA assesses the activity participation and difficulty performing tasks in 4 domains: cognitive, instrumental, basic activities of daily living (ADLs), and mobility. Wilcoxon Sign Rank test was used to analyze the difference in SAGEA scores and activity participation. Results: Twenty-six participants had a mean age of 79, 65% were men, and 84% reported baseline functional deficits. Their SAGEA scores were not different from pre and post-GI cancer (p=0.47). Participants reduced participation from 10 to 9 tasks (p=0.0028), and 69% performed fewer tasks after GI cancer, mostly iADLs. Over 42% reported more difficulty in mobility after GI cancer diagnosis. Conclusions: Individuals may experience participation loss after GI cancer, highlighting the need for functional assessment after cancer diagnoses.

Keywords

• cardiovascular disease
• gastrointestinal cancer
• cancer survivorship
• activities of daily living
• mobility
• activity participation