title: The role of psychological functioning in the use of complementary and alternative methods among disease-free colorectal cancer survivors: a report from the American Cancer Society's studies of cancer survivors.
abstract: BACKGROUND
  The medical and demographic correlates of complementary and alternative medicine (CAM) use among cancer survivors have been well documented. However, the role of psychological functioning in cancer survivors' CAM use and the degree to which such factors apply to survivors of colorectal cancer require additional study. In addition, sex differences in CAM use and its correlates among colorectal cancer survivors are not well understood.
  
  
  METHODS
  By using data from a large-scale national population-based study of quality of life and health behaviors among cancer survivors, the authors examined the prevalence and psychological correlates of CAM use among 252 male and 277 female colorectal cancer survivors.
  
  
  RESULTS
  Use of CAM was more common among women, those with more education, and recipients of chemotherapy and radiation therapy. Several psychological factors predicted increased use of CAM among female colorectal cancer survivors, including anxiety, fear of cancer recurrence, fatigue, vigor, anger, mental confusion, and overall emotional distress. Depression was associated with decreased CAM use among female survivors, both for overall CAM use and across several standard CAM domains. In contrast, psychological functioning had little impact on male colorectal cancer survivors' CAM use. The only nonmedical/demographic variable associated with men's use of CAM was fatigue, which predicted use only of biologically based practices, such as diet and nutritional supplements.
  
  
  CONCLUSIONS
  Psychological functioning has a significant impact on CAM use among female colorectal cancer survivors. Decreased use of CAM among women with depressive symptoms was unexpected and warrants additional investigation.
authors.affiliation: Behavioral Research Center, American Cancer Society, Atlanta, Georgia 30303, USA.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Stein
authors.forename: Chiewkwei
authors.initials: C
authors.lastname: Kaw
authors.forename: Corinne
authors.initials: C
authors.lastname: Crammer
authors.forename: Ted
authors.initials: T
authors.lastname: Gansler
mesh_terms: D000570:American Cancer Society; D001007:Anxiety / Q000523:psychology; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000628:therapy*; D000529:Complementary Therapies / Q000523:psychology*; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D014481:United States