Abstract
BackgroundReceiving a cancer diagnosis can be a major life event which causes distress even years after primary treatment.AimTo examine the prevalence of distress in older patients with cancer (OPCs) up until 5 years post-diagnosis, and identify predictors present at time of diagnosis. Results are compared with reference groups of middle-aged patients with cancer (MPCs) and older patients without a cancer diagnosis (OPs).Design & settingOPCs, MPCs, and OPs participated in a longitudinal cohort study in Belgium and the Netherlands by filling in questionnaires at designated time points from 2010–2019.MethodData from 541 patients were analysed using multivariable logistic regression analyses.ResultsAt baseline, 40% of OPCs, 37% of MPCs, and 17% of OPs reported distress. After 5 years, 35% of OPCs, 23% of MPCs, and 25% of OPs reported distress. No significant predictors for long-term distress in OPCs and OPs were found. For MPCs, it was found that baseline distress (odds ratio [OR] 2.94; 95% confidence intervals [CI] = 1.40 to 6.19) and baseline fatigue (OR 4.71; 95% CI = 1.81 to 12.31) predicted long-term distress.ConclusionDistress is an important problem for people with cancer, with peaks at different moments after diagnosis. Feelings of distress are present shortly after diagnosis but they decrease quickly for the majority of patients. In the long term, however, OPCs in particular appear to be most at risk for distress. This warrants extra attention from primary healthcare professionals, such as GPs who are often patients’ first medical contact point. More research into risk factors occurring later in an illness trajectory might shed more light on predictors for development of long-term distress.
Highlights
A cancer diagnosis, along with the subsequent treatment and period of recovery, can be a disruptive event in people's lives, causing psychological distress
Distress is an important problem for people with cancer, with peaks at different moments after diagnosis
Data for this article were derived as part of the ongoing Kanker bij LIMburgse en Vlaams‐Brabantse Ouderen Project (KLIMOP), a Flemish–Dutch cohort study.[25]
Summary
A cancer diagnosis, along with the subsequent treatment and period of recovery, can be a disruptive event in people's lives, causing psychological distress. Reported prevalence of distress in patients varies, but tends to be relatively high.[1,2,3,4,5,6,7,8,9] Distress in people with cancer has been associated with a lower quality of life.[7] Most studies have focused on distress in the short term, usually up to 1 year after diagnosis and treatment. Findings indicate that distress can persist for a long period after diagnosis and treatment, negatively affecting the quality of life of cancer survivors.[10,11,12,13,14,15,16,17,18]. Receiving a cancer diagnosis can be a major life event which causes distress even years after primary treatment
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