Symptom Clusters and Sentinel Symptoms in Patients With Colorectal Cancer: A Network Analysis

Colorectal cancer (CRC) is one of the most common cancers globally. CRC is the second most prevalent form of cancer in China. The study aimed to construct symptom networks, identify core and sentinel symptoms and analyses the relationship between influencing factors and symptom clusters in CRC patients. We identified symptom clusters and their sentinel symptoms using exploratory factor analysis and the A priori Algorithm in 789 colorectal cancer patients (Yanji City, Jan 2020-Mar 2024). Core symptoms were determined according to the centrality index of the symptom network, while univariate and multifactorial analyses explored factors influencing core and sentinel symptoms in first-diagnosed patients. Four symptom clusters were identified: colorectal cancer-specific, gastrointestinal (feeling bloated as sentinel), insufficient energy (shortness of breath as sentinel), and disease symptom clusters. Core symptoms included changes in bowel habits, influenced by alcohol history and carcinoembryonic antigen (CEA). Feeling bloated was influenced by alcohol history and shortness of breath by alcohol history and marital status. These findings emphasize the importance of early screening and symptom management for at-risk individuals.