Abstract B040: Rural-urban differences in multiple symptoms occurrence in pediatric cancer survivors after treatment completion in Nebraska, United States

Abstract Background Pediatric cancer is the leading cause of death by disease among children. With advanced treatments, survivors are living longer. However, they often experience multiple symptoms even after the treatment completion. Little is known about whether rural-urban residences are associated with multiple symptoms occurrence in pediatric cancer survivors. Methods We conducted a cross-sectional study of 130 pediatric cancer survivors aged 10-25 who completed treatment within eight years from 2 major hospitals in Nebraska. We used a survey to collect data during their hospital visit and the validated Memorial Symptom Assessment Scale tool to collect information on 30 symptoms. We used the PedsQoL instrument to measure the quality of life. We conducted a multiple linear regression model to find the association between rurality and multiple symptoms and to identify factors associated with multiple symptoms at a level of significance with a p-value of less than 0.05 and an adjusted beta coefficient. Results The mean age of participants was 15.00, the mean year since diagnosis and treatment completion was 4.52 and 2.92, respectively, and the mean number of symptoms was 6.18.Difficulty concentrating (49.23%), lack of energy (46.92%), and feeling drowsy (46.92%) were the most common symptoms. The mean total quality of life score was 82.16 out of 100. In the unadjusted model, the association of residence and multiple symptoms was not found to be significant, but when adjusted for possible confounders such as age, race, ethnicity, education, diagnosis, body mass index, health-related quality of life, the association was found to be significant indicating there are a higher number of symptoms in pediatric cancer survivors residing in rural areas compared to urban areas. Quality of life is also poorer when the number of symptoms is higher. Conclusion Even after the treatment completion, multiple symptoms occur in pediatric cancer survivors, and the number of symptoms is higher for those residing in rural areas.Further exploration is needed because of the higher number of symptoms in those residing in rural areas. The association of multiple symptoms with other neighborhood-level socio-demographic indices, such as the area deprivation index, should also be assessed. Citation Format: Krishtee Napit, Don Coulter, Katrina Cordts, Daisy Dai, Evi Farazi, Shinobu Watanabe-Galloway. Rural-urban differences in multiple symptoms occurrence in pediatric cancer survivors after treatment completion in Nebraska, United States [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr B040.