title: Cancer-related health worries and psychological distress among older adult, long-term cancer survivors.
abstract: While long-term survivors (5 years+) do not face the stressors of diagnosis and treatment, they continue to face the uncertainties that survivorship brings: recurrence, other cancers, late effects of treatment, and the potential of a shortened life expectancy. This research focuses on the cancer-related health worries of older adult, long-term cancer survivors, the factors that predict these worries, and their link to traditional measures of psychological distress. Specifically, a model is proposed that identifies the personal (including race and gender) and illness/treatment characteristics of survivors that are significantly associated with cancer-related health worries and their effects on anxiety and depression. Descriptive and multivariate analyses of a random sample of 321 long-term survivors in a major cancer center tumor registry are used to address these issues. About one-third of survivors continue to report worries about recurrence, worries about a second cancer, and worries that symptoms they experience may be from cancer. The regression analyses show that cancer-related health worries is a significant predictor of both depression (beta=0.36) and anxiety (beta=0.21). Race is a significant predictor; being African American is related to fewer cancer-related health worries (beta=-0.22). Having more symptoms during treatment is also a predictor of having more cancer-related health worries (beta=0.20). The most consistent predictor of psychosocial distress is dispositional optimism/pessimism, with more optimistic individuals reporting fewer cancer-related health worries (beta=-0.27), lower levels of both anxiety (beta=-0.16) and depression (beta=-0.23). Overall, for many older adult, long-term survivors, the legacy of cancer continues in terms of cancer-related health worries. In spite of these, for most survivors, their quality of life is not dramatically compromised either physically or psychologically.
authors.affiliation: Department of Sociology, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7124, USA. gtd@Case.edu
authors.forename: Gary T
authors.initials: GT
authors.lastname: Deimling
authors.forename: Karen F
authors.initials: KF
authors.lastname: Bowman
authors.forename: Samantha
authors.initials: S
authors.lastname: Sterns
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Wagner
authors.forename: Boaz
authors.initials: B
authors.lastname: Kahana
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology; D015179:Colorectal Neoplasms / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D013997:Time Factors