Doris M Howell1, Kelly Metcalfe2, Shiying Kong3, Joanne Stephen4, Ivo A Olivotto5, Nancy Baxter6,7, Christine M Friedenreich8,9, Ellen Warner10, Mohammed Reza Akbari11, Kristine McBain12, Steven Narod13, May Lynne Quan14. 1. Division of Supportive Care, Princess Margaret Cancer Research Institute (University Health Network) & Lawrence S. Bloomberg Faculty of Nursing, 610 University Ave. Room 15-617, Toronto, ON, M5G2M9, Canada. doris.howell@uhn.ca. 2. Genetics, Research and External Affairs, Lawrence S. Bloomberg Faculty of Nursing and Women's College Research Institute, University of Toronto, Toronto, ON, Canada. 3. Department of Surgery, Alberta Health Services, Calgary, AB, Canada. 4. Clinical Neurosciences Program, Alberta Health Services, Calgary, AB, Canada. 5. Division of Radiation Oncology, Tom Baker Cancer Centre and Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 6. Department of Surgery, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada. 7. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. 8. Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada. 9. Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 10. Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 11. Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 12. MAP Centre for Urban Health Solutions, Unity Health, Toronto, ON, Canada. 13. Familial Breast Cancer Research Unit, Women's College Research Institute and Department of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 14. Department of Surgery, University of Calgary, Alberta, ON, Canada.
Abstract
PURPOSE: Young women with breast cancer (YWBC) are an understudied population and there are limited data on risk factors for psychological morbidity early in diagnosis. We examined psychological morbidity (anxiety, depression, stress symptoms), well-being and associated risk factors. METHODS: A total of 845 women from a pan-Canadian, multicentre inception cohort study of YWBC (age ≤ 40) who completed Patient Reported Outcome Measures (PROMs) after their initial surgical consultation and prior to surgical or other treatments were included. Multivariate regression analyses identified risk factors (i.e. parenting young children) associated with psychological morbidity and whether coping self-efficacy was protective. RESULTS: Rates of clinically significant anxiety (n = 683, 69.1%) and depression (n = 422, 42.7%) were high but lower for stress symptoms (n = 67, 6.8%). Probability of anxiety was high for women with a previous history of depression (OR 2.02, P = 0.03, CI 1.09-3.74) and working full-time (OR 1.76, P = 0.05 CI 1.02-2.77). Whereas, pre-existing depression (OR 2.91, P = 0.01, CI 1.36-6.01), younger children (age ≤ 10) (OR 1.69, P = 0.05, CI 1.01-2.93), and income > $100,000 (OR 2.06, P = 0.02, CI 1.18-3.64) were risk factors for depression. Coping self-efficacy was protective with a decreased risk of anxiety (OR 0.11, P ≤ 0.01 CI 0.04-0.28), depression (OR 0.03, P ≤ .01, CI 0.01-0.16), stress symptoms (OR 0.17, P ≤ .01, CI 0.04-0.65) and higher psychosocial well-being with a gain of 19.68 points (P < 0.01) for high levels of CSE (> mean plus 1 SD). Those with lower levels of neurosis had less negative outcomes. CONCLUSION: Young women with breast cancer are vulnerable to psychological morbidity early in diagnosis, particularly those with low coping self-efficacy and may benefit from earlier supportive care.
PURPOSE: Young women with breast cancer (YWBC) are an understudied population and there are limited data on risk factors for psychological morbidity early in diagnosis. We examined psychological morbidity (anxiety, depression, stress symptoms), well-being and associated risk factors. METHODS: A total of 845 women from a pan-Canadian, multicentre inception cohort study of YWBC (age ≤ 40) who completed Patient Reported Outcome Measures (PROMs) after their initial surgical consultation and prior to surgical or other treatments were included. Multivariate regression analyses identified risk factors (i.e. parenting young children) associated with psychological morbidity and whether coping self-efficacy was protective. RESULTS: Rates of clinically significant anxiety (n = 683, 69.1%) and depression (n = 422, 42.7%) were high but lower for stress symptoms (n = 67, 6.8%). Probability of anxiety was high for women with a previous history of depression (OR 2.02, P = 0.03, CI 1.09-3.74) and working full-time (OR 1.76, P = 0.05 CI 1.02-2.77). Whereas, pre-existing depression (OR 2.91, P = 0.01, CI 1.36-6.01), younger children (age ≤ 10) (OR 1.69, P = 0.05, CI 1.01-2.93), and income > $100,000 (OR 2.06, P = 0.02, CI 1.18-3.64) were risk factors for depression. Coping self-efficacy was protective with a decreased risk of anxiety (OR 0.11, P ≤ 0.01 CI 0.04-0.28), depression (OR 0.03, P ≤ .01, CI 0.01-0.16), stress symptoms (OR 0.17, P ≤ .01, CI 0.04-0.65) and higher psychosocial well-being with a gain of 19.68 points (P < 0.01) for high levels of CSE (> mean plus 1 SD). Those with lower levels of neurosis had less negative outcomes. CONCLUSION: Young women with breast cancer are vulnerable to psychological morbidity early in diagnosis, particularly those with low coping self-efficacy and may benefit from earlier supportive care.
Authors: Annette L Stanton; Joshua F Wiley; Jennifer L Krull; Catherine M Crespi; Constance Hammen; John J B Allen; Martha L Barrón; Alexandra Jorge; Karen L Weihs Journal: Breast Cancer Res Treat Date: 2015-09-29 Impact factor: 4.872
Authors: Candyce H Kroenke; Bernard Rosner; Wendy Y Chen; Ichiro Kawachi; Graham A Colditz; Michelle D Holmes Journal: J Clin Oncol Date: 2004-05-15 Impact factor: 44.544
Authors: Hussein A Assi; Katia E Khoury; Haifa Dbouk; Lana E Khalil; Tarek H Mouhieddine; Nagi S El Saghir Journal: J Thorac Dis Date: 2013-06 Impact factor: 2.895