Is Psychological Wellbeing Impaired in Long Term Survivors of Breast Cancer?
- 1 March 1995
- journal article
- research article
- Published by SAGE Publications in Journal of Medical Screening
- Vol. 2 (1), 5-9
- https://doi.org/10.1177/096914139500200103
Abstract
Objective To measure anxiety and depression in long term survivors of breast cancer. Design Case-control study. Setting Follow up of the trial of early detection of breast cancer in the South West Surrey Health District. Subjects 331 patients with breast cancer aged 50–78, attending mammographic follow up, who had been invited to screening before diagnosis, and 584 controls who had attended the same clinic but did not have breast cancer. The sample included 290 pairs matched by screening attendance pattern and year of birth. Main Outcome Measure – Anxiety and depression scores on the Hospital Anxiety and Depression Scale. Results Significantly fewer symptoms of anxiety and depression were reported by patients with cancer than by controls and significantly fewer had high scores suggesting the presence of psychological morbidity meriting treatment. Among the patients with cancer anxiety was more common at the first annual follow up than at later visits. Symptom scores were not significantly related to the manner of detection or to the type of initial treatment. Potentially confounding social and personal factors did not account for the differences between patients with cancer and controls. Conclusion The prevalence of anxiety and depression is not increased in long term survivors of breast cancer who are apparently free from disease and is not substantially affected by the manner in which a cancer is detected or by the treatment given. In the light of these findings it is difficult to justify large “quality adjustments” to the estimates of recurrence-free years of life saved by screening. Those who counsel patients with breast cancer should be aware that although the initial distress can be severe, meriting psychological treatment, patients do recover their normal ability to enjoy life.Keywords
This publication has 19 references indexed in Scilit:
- A cost utility analysis of mammography screening in AustraliaSocial Science & Medicine, 1992
- Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patientsEuropean Journal of Cancer and Clinical Oncology, 1991
- Psychiatric morbidity in patients with advanced cancer of the breast: prevalence measured by two self-rating questionnairesBritish Journal of Cancer, 1991
- Assessing quality of life in cancer patientsBritish Journal of Cancer, 1989
- Physical and psychosocial functioning and adjustment to breast cancer. Long-term follow-up of a screening populationCancer, 1989
- The Hospital Anxiety and Depression ScaleActa Psychiatrica Scandinavica, 1983
- Trial of early detection of breast cancerBritish Journal of Cancer, 1981
- Effect of counselling on the psychiatric morbidity associated with mastectomy.BMJ, 1980
- Psychological and social adjustment to mastectomy.A two-year follow-up studyCancer, 1977
- The quality of survival in breast cancer: A case-control comparisonCancer, 1974