title: Disease stage and psychosocial outcomes in colorectal cancer.
abstract: OBJECTIVE
  Disease stage is a strong predictor of cancer survival and is therefore assumed to influence psychosocial outcomes. However, existing findings are inconsistent, perhaps reflecting limited sample sizes, especially among patients with advanced disease. There has also been an emphasis on breast cancer, resulting in a focus on outcomes among women. The present study investigated associations between disease stage and psychosocial wellbeing in 128 patients (52% male, 48% female) diagnosed with colorectal cancer.
  
  
  METHODS
  Patients diagnosed within the past year in a single hospital were invited to participate in a questionnaire study and give permission for staging information to be obtained from their medical records. The questionnaire included measures of anxiety, depression, quality of life, social support, social difficulties and quality of medical interactions.
  
  
  RESULTS
  Patients with more advanced disease were more anxious (P < 0.01) and depressed (P < 0.001), perceived their social support as lower (P < 0.01), and had a worse quality of life (P < 0.01). Women with advanced disease had more severe colorectal symptoms (P < 0.01), and worse physical (P < 0.01) and emotional (P < 0.05) quality of life than men.
  
  
  CONCLUSIONS
  Patients with advanced colorectal cancer have unmet psychosocial needs. Women may be more strongly affected by advanced disease than men.
authors: Department of Epidemiology and Public Health, Health Behavior Research Centre, University College London, London, UK.
authors: A E
authors: AE
authors: Simon
authors: M R
authors: MR
authors: Thompson
authors: K
authors: K
authors: Flashman
authors: J
authors: J
authors: Wardle
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology*; D010054:Brief Psychiatric Rating Scale; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000145:classification / Q000523:psychology*; D003863:Depression; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D012944:Social Support