Psychological Distress, Health Behaviors, and Benefit Finding in Survivors of Multiple Primary Cancers: Results From the 2010 Livestrong Survey.
Sarah M Belcher, Carissa A Low, Donna M Posluszny and 3 others
PMID 29052655WHAT IT FOUND
Having multiple primary cancers was linked with psychological distress and keeping up with medical care, not with healthy lifestyle behaviors or seeing cancer as bringing personal benefit.
Key findings
01Having multiple primary cancers was associated with psychological distress and positive healthcare utilization, but not with healthy lifestyle behaviors or benefit finding.
02Multiple primary cancer survivors were more likely than single cancer survivors to report living with cancer as a chronic illness.
03The final psychological distress model accounted for 8% of model variance, and the authors noted other important factors could not be included.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that multiple primary cancer caused distress or that distress led to behaviors. It was a secondary analysis of survey items, and psychological distress severity was not collected. The final models accounted for 8% of variance in psychological distress, 1% in healthy lifestyle behaviors, 4% in healthcare utilization, and 3% in benefit finding, and the authors noted other important factors were not included. Multiple primary cancer survivors were 5.7% of the sample, slightly less than the 8% representation typically found in the overall cancer survivor population. The authors excluded cases in which survivors reported a common site of metastasis as their second cancer, which may have removed true multiple primary cancer cases. The online voluntary Livestrong respondents were younger, less diverse, more educated, and wealthier than expected, which may reduce generalizability to the general cancer survivor population. Missing data, mostly in health behavior outcomes, may bias findings.
Declared interests
The supplied publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that multiple primary cancer causes distress or that screening improves outcomes. This was a cross-sectional survey, and no intervention was tested.