| Sumario: | Background & Significance: Cancer survivors frequently report ongoing symptoms that persist long after treatment completion, affecting functioning and quality of life. While age-related differences in survivorship outcomes are documented, less is known about symptom patterns across age groups. Under-standing these differences is critical for tailoring supportive care and optimizing long-term outcomes. Purpose: This study compared symptom burden between younger (<65 years) and older (>65 years) cancer survivors and examined demographic and survivorship correlates of symptoms within each age group. Methods: This retrospective, cross-sectional study analyzed 2023 data from the MD Anderson Symptom Inventory completed by survivors in six survivorship clinics at a comprehensive cancer center. Outcomes were moderate-severe (>4/10) ratings across 13 symptom domains. Younger and older survivors were matched 1:1 using propensity scores (sex, years in survivorship care) and exact matching by clinic. Logistic regression models estimated adjusted odds ratios (aORs), controlling for sex, race/ethnicity, and years in survivorship care. Secondary models examined predictors of symptoms within each age group. Findings and Interpretations: Analyses included 980 younger and 980 older survivors. Compared with older survivors, younger survivors had higher odds of problems remembering (aOR=1.35, p=.023) and lower odds of shortness of breath (aOR=0.58, p=.042). Among younger survivors, women were more likely than men to report fatigue, nausea, neuropathy, pain, sadness, and sleep disturbance (aORs^.59-4.17, ps<.05). Racial/ethnic minority survivors reported greater odds of appetite loss, dry mouth, and sadness (aORs=1.50 - 2.01, ps<.05). Survivors with <1 year in survivorship care were more likely to report nausea, pain, and remembering problems (aORs^.63-2.30, ps<.05) compared with those with >5 years in survivorship care. Among older survivors, women were more likely than men to report sleep disturbance (aOR=1.63, p=0.01). Survivors with <1 year in survivorship care were more likely to report appetite loss, distress, dry mouth, and fatigue (aORs^.55-2.19, ps<.05) compared with those with >5 years in survivorship care. Discussion: Younger survivors reported more cognitive symptoms, whereas older survivors more often endorsed physical symptoms such as shortness of breath. Sex, race/ethnicity, and duration in survivorship care were significant correlates for younger survivors, while duration in survivorship care was the primary predictor for older survivors. These findings highlight the importance of age-tailored assessment and interventions. Incorporating patient-reported outcomes into survivorship care can help oncology nurses identify at-risk subgroups and deliver targeted supportive care that improves survivors' quality of life.
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