{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T10:01:36Z","timestamp":1777543296560,"version":"3.51.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"2","funder":[{"DOI":"10.13039\/501100025092","name":"Ontario Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025092","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100025090","name":"Ministry of Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Personalized Health Catalyst"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with pancreatic ductal adenocarcinoma (PDAC) experience debilitating symptoms, yet factors associated with symptom burden and severity are not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population-based cohort study included patients diagnosed with PDAC and who completed Edmonton Symptom Assessment System (ESAS) between 1 month before and 2 months after diagnosis between January 1, 2007 and December 31, 2020 in Ontario, Canada. The ESAS contains 9 symptoms on a scale from 0 to 10. The primary outcome was moderate to severe (ESAS scores \u22654) symptoms (pain, tiredness, nausea, depression, anxiety, drowsiness, loss of appetite, well-being, and shortness of breath) 2-6\u2009months after diagnosis. We used multivariable logistic regression models to evaluate associations between the primary outcome and baseline demographic and clinical variables, cancer-specific factors, and baseline symptom scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 4918 patients (mean age 68\u2009years, 52% male). Near the time of diagnosis, 13.8% (nausea) to 38.5% (well-being) of patients reported moderate to severe symptoms. At 2-6\u2009months after diagnosis, 23.0% (dyspnea) to 57.5% (poor well-being) reported moderate to severe symptoms. A range of baseline demographic, clinical, and cancer-specific risk factors were identified for reporting of moderate to severe symptoms. The presence of baseline symptoms for each of the 9 included symptoms was associated with reporting of the same symptom with moderate to high severity 2-6\u2009months after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with PDAC face a high symptom burden following diagnosis. Universal physician symptom screening for patients diagnosed with PDAC may enable improved symptom identification and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jcag\/gwaf040","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:59:05Z","timestamp":1769086745000},"page":"100-109","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with physical and mental health symptoms in pancreatic adenocarcinoma: a population-based cohort study"],"prefix":"10.1093","volume":"9","author":[{"given":"Paul D","family":"James","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, University Health Network , Toronto, Ontario M5G 2C4,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5090-7685","authenticated-orcid":false,"given":"Rishad","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and 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