Gastrointestinal and respiratory symptom reporting by race among cancer patients in an RSM Program

Abstract Background Gastrointestinal (GI) and respiratory symptoms are common among patients undergoing cancer treatment, yet little is known about the symptom burdens and management by race. Remote Symptom Monitoring (RSM) with electronic Patient-Reported Outcomes (ePROs) enhances symptom tracking and intervention; however, its impact on racial disparities in symptom reporting remains unclear. Objective This study examined racial differences in moderate to severe symptom reporting among patients enrolled in an ePRO-based RSM program, described how the frequency of reported symptoms differed across early and later periods of enrollment, and characterized patient engagement with the program. Methodology We conducted a retrospective cohort study of 924 cancer patients enrolled in an RSM program at a large academic medical center. Patients self-reported GI (constipation, diarrhea, decreased appetite, nausea, vomiting) and respiratory (cough, shortness of breath) symptoms weekly for six months. Symptoms were categorized as moderate/severe versus none/mild using the PRO-CTCAE grading tool. A generalized linear mixed-effects Poisson log-link model, adjusted for demographic and clinical factors, compared the frequency of moderate/severe symptom reporting between Black and White patients at 0 to 3 and 4 to 6 months post RSM enrolment. Results We observed no significant differences in reported moderate/severe GI (Black: 18%, White: 20%; RR: 0.92, 95% CI: 0.76–1.09) or respiratory symptoms (Black: 5%, White: 4%; RR: 1.25, 95% CI: 0.91–1.70) by race. Across all patients, the proportion of surveys reporting moderate to severe symptoms was lower in months 4 to 6 than in months 0 to 3, with a 29% lower frequency for GI and 26% lower for respiratory symptoms. Consistent responding was associated with lower reported symptom burden. Conclusion Our findings show no significant racial differences in reported moderate to severe GI or respiratory symptoms within this RSM program. Whether the program itself reduces symptom burden cannot be determined from this single-group design.