title: The use of a patient-reported outcome questionnaire to assess cancer survivorship concerns and psychosocial outcomes among recent survivors.
abstract: Survivor distress is well represented in the literature, but less is known about survivors' concerns and how these relate to adaptation. Using a newly designed Survivorship Concern Scale, we examined concerns and their relationship to psychosocial adaptation among recent breast cancer (BC) survivors.
  
  
  
  One hundred forty-three stage 0-III BC survivors completed an online assessment including the Survivorship Concern Scale (0-3 scale; alpha = 0.91), unmet needs, quality of life (QoL), and anxiety and depressive symptoms within 1 year of end of treatment.
  
  
  
  Participants were predominately white (76%), middle-aged (51 years), married (70%), and college educated (79%). Eighty-two percent were stage I or II at diagnosis. Mean degree of survivorship concern was moderate (M = 1.75, SD = 0.70) though variable (range = 0.12-3.00). Survivorship concerns were not significantly related to disease, treatment, or demographic variables except income (p = 0.02). Degree of survivorship concern was significantly associated with all indices of psychosocial adaptation: unmet need (r = 0.50), physical and mental QoL (r = -0.32 and r = -0.32, respectively), depressive symptoms (r = 0.21), and anxiety symptoms (r = 0.51; all p < 0.001). Binary logistic regression suggested that each one-point increase in degree of average concern increased the odds for elevated depressive symptoms by 2.83 (p = 0.03) and increased the odds of elevated anxiety symptoms by 3.69 (p < 0.001).
  
  
  
  Survivorship concerns in the year following treatment are moderate but variable. Concerns are associated with QoL, unmet need, and psychosocial adaptation. Adequately addressing concerns may be a way to improve psychosocial outcomes early in the survivorship trajectory.
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Steven.Palmer2@UPHS.UPENN.EDU.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Palmer
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Carrie T
authors.initials: CT
authors.lastname: Stricker
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.|Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Angela M
authors.initials: AM
authors.lastname: DeMichele
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Schapira
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.|Department of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Griggs
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Jacobs
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors / Q000523:psychology
keywords: Cancer; Oncology; Quality of life; Survivorship; Unmet need