title: Socioeconomic disparities in psychosocial wellbeing in cancer patients.
abstract: This study tested the hypothesis that cancer patients from lower socioeconomic status (SES) backgrounds have poorer adjustment to cancer. In a longitudinal study of 352 patients with breast, prostate or colorectal cancer, SES was indexed as a composite of educational level, car and home ownership. Patients were classified as higher (3 markers: car, home and higher education) or lower (up to 2 markers) SES. Patients completed measures of depression, anxiety, quality-of-life, social difficulties and benefit-finding at 2 months (Time 1) and 10 months (Time 2) after diagnosis. Data on disease stage, treatment and co-morbid illness were also collected. At Time 1, lower SES patients were more anxious and depressed and had worse quality-of-life and more social difficulties. Psychological wellbeing improved on all measures by follow-up, and although not significant, the trend was towards diminishing, rather than increasing, differences in wellbeing between higher and lower SES groups. Acute psychosocial reactions to a cancer diagnosis appeared to be greater amongst patients with fewer educational and material resources, but longer-term adjustment did not appear to be any worse in lower SES patients.
authors.affiliation: Cancer Research UK Health Behavior Unit, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK. alice.simon@ucl.ac.uk
authors.forename: Alice E
authors.initials: AE
authors.lastname: Simon
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D004522:Educational Status; D004739:England; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012923:Social Class; D013315:Stress, Psychological / Q000209:etiology