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Prognostic significance of psychosocial factors in African‐American and white breast cancer patients
Author(s) -
SolerVila Hosanna,
Kasl Stanislav V.,
Jones Beth A.
Publication year - 2003
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.11670
Subject(s) - medicine , breast cancer , psychosocial , population , cohort , hazard ratio , proportional hazards model , coping (psychology) , cancer , demography , gynecology , gerontology , oncology , confidence interval , clinical psychology , psychiatry , environmental health , sociology
BACKGROUND It has been suggested that psychosocial factors, such as coping and emotional support, influence cancer survival, but results have been inconclusive. Given the scarce data from racially/ethnically diverse populations, the authors investigated the prognostic significance of selected psychosocial variables in a cohort of African‐American women and white women with breast cancer. METHODS The authors examined the effects of coping styles, perceived emotional support, fatalism, and health locus of control on survival for a population‐based cohort of 145 African‐American women and 177 white women who were diagnosed with breast cancer in Connecticut between January 1987 and March 1989 and were followed for survival for approximately 10 years. Cox proportional hazards models were adjusted for sociodemographic factors, biomedical factors (American Joint Committee on Cancer stage at diagnosis, histologic grade, comorbidity, obesity, menopausal status, and treatment), and lifestyle factors. RESULTS Fully adjusted models showed that lower perceived emotional support (disagreeing with the statement, “cancer is a topic I can talk about freely with my friends/relatives”) at diagnosis was associated with a higher risk of death from any cause (hazard ratio, 1.39; 95% confidence interval, 1.09–1.79). Adjustment for additional tumor characteristics (nuclear grade, estrogen and progesterone receptor status) and genetic alterations (p53, HER‐2) did not alter the findings. No other psychosocial factors significantly predicted survival in patients with breast cancer. CONCLUSIONS Higher levels of perceived emotional support showed a moderate but significant association with increased survival in African‐American and white women with breast cancer who were followed for 10 years after diagnosis when adjusting for known prognostic factors. Survival was not related to coping styles, fatalism, or health locus of control. Cancer 2003;98:1299–308. © 2003 American Cancer Society. DOI 10.1002/cncr.11670