Prevalence of post-traumatic stress disorder and associated factors among adult sarcoma patients.

Abstract

11557 Background: A cancer diagnosis and treatment can be extremely stressful and even traumatic for sarcoma patients. However, research on prevalence and risk factors for developing post-traumatic stress disorder (PTSD) symptoms among sarcoma patients has not been well studied. Methods: This study used survey data from participants recruited between 4/2022 and 12/2025 for the “Cohort to Augment the Understanding of Sarcoma Survivorship Across the Lifespan” (CAUSAL) study. PTSD symptoms were assessed via the 22-item Impact of Event Scale-Revised (IES-R) at cohort enrollment, and a total IES-R score of ³33 indicates PTSD symptomatology. Associations of demographics and clinical characteristics with PTSD symptoms were evaluated using logistic regression models. The association between PTSD symptoms and health-related quality of life (HRQOL), measured via T-scores for the seven core domains of the PROMIS-57 scale, was then assessed using multivariable linear regression models adjusted for potential confounders. Results: Among 1,112 adult sarcoma patients (509 on active treatment and 603 survivors), there are 605 females and 507 males, aged between 18 and 84 (mean age: 54.8). 18.1% of sarcoma patients/survivors reported experiencing PTSD symptoms. Female (20.5%) and younger (15.9-24.3%) sarcoma patients were significantly more likely to experience PTSD symptoms, whereas those with higher household incomes were significantly less likely to experience PTSD symptoms (11.6%-17.6%). Patients who were 5+ years post-diagnosis were less likely to experience PTSD symptoms with adjusted odds ratios (aOR) and 95% confidence intervals (CIs) of 0.56 (0.34, 0.89), compared to those who were < 18 months post-diagnosis. Regular exercise (aOR [95 CI] = 0.59 [0.42, 0.83]) and having emotional support (aOR [95 CI] = 0.63 [0.41, 0.97] for medium and 0.26 [0.15, 0.42] for high support) were inversely associated with PTSD prevalence. PTSD symptoms were significantly associated with a decreased T-score of physical function and social roles and activities with ß(95% CI) of -4.2 (-5.7, -2.7) and -6.8 (-8.3, -5.2), respectively and increased scores for anxiety (ß = 8.9; 95% CI: 7.6, 10.0), depression (ß = 9.4; 95% CI: 8.2, 11.0), fatigue (ß = 7.0; 95% CI: 5.5, 8.5), sleep disturbance (ß = 7.9; 95% CI: 6.6, 9.3), and pain interference (ß = 6.7; 95% CI: 5.2, 8.2). Conclusions: PTSD symptoms were reported by an average 18% sarcoma patients and survivors, particularly among female, younger patients, non-exercisers, and those with lower income and low emotional support. PTSD was associated with poor HRQOL. Long-term survival, regular exercise, and increased emotional support were inversely associated with the prevalence of PTSD symptoms. Psychological support and exercise programs should be offered during active cancer treatment and follow-up surveillance to reduce PTSD symptoms in sarcoma patients and survivors.