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Psychosocial factors and mortality in women with early stage endometrial cancer
Author(s) -
Telepak Laura C.,
Jensen Sally E.,
Dodd Stacy M.,
Morgan Linda S.,
Pereira Deidre B.
Publication year - 2014
Publication title -
british journal of health psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.05
H-Index - 88
eISSN - 2044-8287
pISSN - 1359-107X
DOI - 10.1111/bjhp.12070
Subject(s) - psychosocial , medicine , endometrial cancer , coping (psychology) , hazard ratio , comorbidity , hysterectomy , proportional hazards model , disease , cancer , gynecology , clinical psychology , surgery , psychiatry , confidence interval
Objectives Psychosocial factors have previously been linked with survival and mortality in cancer populations. Little evidence is available about the relationship between these factors and outcomes in gynaecologic cancer populations, particularly endometrial cancer, the fourth most common cancer among women. This study examined the relationship between several psychosocial factors prior to surgical resection and risk of all‐cause mortality in women with endometrial cancer. Design The study utilized a non‐experimental, longitudinal design. Methods Participants were 87 women ( M age = 60.69 years, SD age = 9.12 years) who were diagnosed with T 1 N 0– T 3 N 2 endometrial cancer and subsequently underwent surgery. Participants provided psychosocial data immediately prior to surgery. Survival statuses 4–5 years post‐diagnoses were abstracted via medical record review. C ox regression was employed for the survival analysis. Results Of the 87 women in this sample, 21 women died during the 4‐ to 5‐year follow‐up. Adjusting for age, presence of regional disease and medical comorbidity severity (known biomedical prognostic factors), greater use of an active coping style prior to surgery was significantly associated with a lower probability of all‐cause mortality, hazard ratio ( HR ) = 0.78, p = .04. Life stress, depressive symptoms, use of self‐distraction coping, receipt of emotional support and endometrial cancer quality of life prior to surgery were not significantly associated with all‐cause mortality 4–5 years following diagnosis. Conclusions Greater use of active coping prior to surgery for suspected endometrial cancer is associated with lower probability of all‐cause mortality 4–5 years post‐surgery. Future research should attempt to replicate these relationships in a larger and more representative sample and examine potential behavioural and neuroendocrine/immune mediators of this relationship. Statement of contribution What is already known on this subject? Psychosocial factors have previously been linked with clinical outcomes in a variety of cancer populations. With regards to gynecologic cancer, the majority of the research has been conducted in ovarian cancer and examines the protective role of social support in mortality outcomes. What does this study add?Demonstrates association between active coping during perioperative period and 5 year survival. Demonstrates psychosocial–survival relationship exists independent of biobehavioral factors.