title: The prevalence, severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study.
abstract: OBJECTIVE
  This study aimed to establish the prevalence, severity, and correlates of psychological distress and impaired generic health-related quality of life (HRQOL) in testicular cancer (TC) survivors.
  
  
  METHODS
  Men who had completed active anti-cancer treatment for TC between 6 months and 5 years previously showing no evidence of recurrence were recruited from 14 Australian cancer centers from September 2009 to February 2011. Participants completed a self-report questionnaire measuring demographic, disease, and treatment information, psychological distress (i.e., depression, anxiety, and stress; DASS21), generic health-related quality of life (HRQOL; SF-36v2), TC-specific HRQOL (EORTC QLQ-TC26), coping (MAC), social support (DUFSS), and unmet needs (CaSUN).
  
  
  RESULTS
  Of 486 eligible TC survivors, 244 (50.2%) completed the questionnaire. Compared with normative data, TC survivors reported: small but statistically significant increases in mean levels of anxiety and depression; a greater prevalence of moderate to extremely severe anxiety (19%) and depression (20%); and significant deficits to mostly mental aspects of generic HRQOL. The most problematic TC-specific HRQOL issues (e.g., fear of recurrence) were also more mental than physical. In multiple regression analyses, the strongest correlates of psychological distress and impaired generic HRQOL were psychosocial (e.g., helpless/hopeless coping and lower social support) rather than disease or treatment factors.
  
  
  CONCLUSIONS
  Generally, TC survivors appear to experience mild psychological distress and HRQOL impairments, while a vulnerable subgroup experience more severe morbidity.
  
  
  CONCLUSIONS
  There is a need to identify TC survivors at risk of poorer outcomes and for interventions to target the areas of greatest impairment (i.e., psychological distress and mental HRQOL).
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia. allan.smith@sydney.edu.au.|Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia. allan.smith@sydney.edu.au.
authors.forename: Allan Ben
authors.initials: AB
authors.lastname: Smith
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
authors.affiliation: Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Olver
authors.affiliation: Improving Palliative Care through Clinical Trials (ImPaCCT), South Western Sydney Clinical School, The University of New South Wales, and Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Luckett
authors.affiliation: Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.|Chris O'Brien Lifehouse and University of Sydney, Sydney, NSW, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Grimison
authors.affiliation: Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.|Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Guy C
authors.initials: GC
authors.lastname: Toner
authors.affiliation: Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.|Chris O'Brien Lifehouse, Sydney, NSW, Australia.|Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Stockler
authors.affiliation: Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.|Prince of Wales Hospital, Sydney, NSW, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hovey
authors.affiliation: Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.|CanSpeak, Sydney, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Stubbs
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Turner
authors.affiliation: Chris O'Brien Lifehouse, Sydney, NSW, Australia.|Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Hruby
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Howard
authors.initials: H
authors.lastname: Gurney
authors.affiliation: Liverpool Hospital, Sydney, NSW, Australia.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Alam
authors.affiliation: Chris O'Brien Lifehouse, Sydney, NSW, Australia.
authors.forename: Keith
authors.initials: K
authors.lastname: Cox
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia.|Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.|Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
authors.forename: Madeleine T
authors.initials: MT
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D013736:Testicular Neoplasms / Q000523:psychology*; D055815:Young Adult
keywords: Health-related quality of life; Oncology; Psychological distress; Survivorship; Testicular cancer