title: Cancer-specific beliefs and survival in nonmetastatic colorectal cancer patients.
abstract: BACKGROUND
  Colorectal cancer (CRC) is the third leading cause of cancer mortality in the United States. Associations between cancer-specific beliefs (beliefs) and survival have been observed among other cancer populations, but similar research in CRC patients is virtually nonexistent, especially in racially diverse populations. The relationship between beliefs and survival was investigated in a cohort of African Americans and non-Hispanic whites with newly diagnosed nonmetastatic CRC, followed for up to 15 years.
  
  
  METHODS
  The authors analyzed data from a population-based cohort of 286 individuals (115 African Americans and 171 whites, approximately 52% women) diagnosed with nonmetastatic CRC in Connecticut, 1987 to 1991. Cox proportional hazards models were adjusted for sociodemographic (age, sex, race, education, income, occupational status, marital status) and biomedical (stage at diagnosis, histological grade, treatment) variables.
  
  
  RESULTS
  Not believing in the curability of cancer increased the risk of all-cause mortality (hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.06-2.39) and CRC-specific mortality (HR, 1.65; 95% CI, 0.90-3.03; P=.10). These multivariate estimates were not altered by additional adjustment for insurance coverage, obesity, smoking, alcohol consumption, or comorbidity. Furthermore, the association between perceived curability and survival did not vary significantly by key sociodemographic or biomedical factors. Other beliefs were not associated with survival.
  
  
  CONCLUSIONS
  Among a racially diverse cohort of men and women with CRC, believing in the curability of cancer was independently associated with survival over a 15-year period. Confirmation of the role of cancer-specific beliefs on survival and study of the potential biobehavioral mechanisms is needed. Findings may inform the design of interventions for cancer survivors.
authors.affiliation: Department of Epidemiology and Public Health, Sylvester Comprehensive Cancer Center, Leonard Miller School of Medicine, University of Miami, Miami, Florida 33136, USA. hsoler@med.miami.edu
authors.forename: Hosanna
authors.initials: H
authors.lastname: Soler-Vilá
authors.forename: Robert
authors.initials: R
authors.lastname: Dubrow
authors.forename: Vivian I
authors.initials: VI
authors.lastname: Franco
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Saathoff
authors.forename: Stanislav V
authors.initials: SV
authors.lastname: Kasl
authors.forename: Beth A
authors.initials: BA
authors.lastname: Jones
mesh_terms: D001741:Black or African American; D000368:Aged; D001294:Attitude to Health; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology; D044465:White People