title: The impact of a cancer diagnosis on health and well-being: a prospective, population-based study.
abstract: Little is known about the trajectory of health and well-being from before to after a cancer diagnosis. This study aimed to examine changes in health and well-being across three time points (0-2 years before a cancer diagnosis, 0-2 years post-diagnosis and 2-4 years post-diagnosis) in individuals receiving a new cancer diagnosis, and at matched time points in a cancer-free comparison group.
  
  
  
  Data were from waves 1-6 of the English Longitudinal Study of Ageing. Repeated-measures ANOVAs were used to examine differences in self-rated health, mobility impairments, activities of daily living impairments, quality of life, depressive symptoms and life satisfaction by group and time, and group-by-time interactions.
  
  
  
  Of the 4565 participants with data from three time points, 444 (9.7%) reported a new cancer diagnosis. Those in the cancer group reported poorer self-rated health (p < .001), quality of life (p < .001) and life satisfaction (p < .01) than participants in the comparison group, and a higher proportion reported depressive symptoms (p < .001) and impairments in mobility (p < .001) and activities of daily living (p < .001). All markers of health and well-being worsened significantly over time. The group-by-time interaction was significant for self-rated health (p < .001), with a greater decline in health over time in the cancer group.
  
  
  
  Cancer survivors in this sample had poorer health and well-being than those with no diagnosis, and self-rated health deteriorated more rapidly following a cancer diagnosis. Screening for these factors around the time of a cancer diagnosis could allow for interventions to be targeted effectively and improve the health and well-being of cancer survivors. © 2015 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Williams
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Jackson
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Beeken
authors.affiliation: Psychobiology Group, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003863:Depression / Q000175:diagnosis; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors / Q000523:psychology*
keywords: cancer; depression; longitudinal; oncology; quality of life; survivorship