Cancer-Specific beliefs and survival in nonmetastatic colorectal cancer patients§

Authors

  • Hosanna Soler-Vilá PhD,

    Corresponding author
    1. Department of Epidemiology and Public Health and Sylvester Comprehensive Cancer Center, Leonard Miller School of Medicine at University of Miami, Miami, Florida
    • Epidemiology and Public Health & Sylvester Comprehensive Cancer Center, University of Miami Leonard Miller School of Medicine, Clinical Research Building, 1120 N.W. 14 Street, Suite 1507, Miami, FL 33136
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    • Fax: (305) 243-2997

  • Robert Dubrow MD, PhD,

    1. Yale School of Public Health, Yale University School of Medicine, New Haven, Connecticut
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  • Vivian I. Franco MPH,

    1. Department of Epidemiology and Public Health and Sylvester Comprehensive Cancer Center, Leonard Miller School of Medicine at University of Miami, Miami, Florida
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  • Andrea K. Saathoff MS Ed,

    1. Department of Educational Psychology Counseling Psychology Doctoral Program, University of Texas at Austin, Austin, Texas
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  • Stanislav V. Kasl PhD,

    1. Yale School of Public Health, Yale University School of Medicine, New Haven, Connecticut
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  • Beth A. Jones PhD, MPH

    1. Yale School of Public Health, Yale University School of Medicine, New Haven, Connecticut
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  • Cosponsored by the National Cancer Institute's Office of Cancer Survivorship, the Office of Cancer Survivorship of the Centers for Disease Control and Prevention, and the American Cancer Society's Behavioral Research Center.

  • Andrea Saathoff was affiliated with the Leonard Miller School of Medicine at University of Miami during the study period.

  • Certain data used in this study were obtained from the Connecticut Tumor Registry located in the Connecticut Department of Public Health. The authors assume full responsibility for analyses and interpretation of these data.

  • §

    Presented at the Fourth Biennial Cancer Survivorship Research Conference entitled “Cancer Survivorship Research: Mapping the New Challenges,” Atlanta, Georgia, June 18-20, 2008.

Abstract

BACKGROUND:

Colorectal cancer (CRC) is the third leading cause of cancer mortality in the United States. Associations between cancer-specific beliefs (beliefs) and survival have been observed among other cancer populations, but similar research in CRC patients is virtually nonexistent, especially in racially diverse populations. The relationship between beliefs and survival was investigated in a cohort of African Americans and non-Hispanic whites with newly diagnosed nonmetastatic CRC, followed for up to 15 years.

METHODS:

The authors analyzed data from a population-based cohort of 286 individuals (115 African Americans and 171 whites, approximately 52% women) diagnosed with nonmetastatic CRC in Connecticut, 1987 to 1991. Cox proportional hazards models were adjusted for sociodemographic (age, sex, race, education, income, occupational status, marital status) and biomedical (stage at diagnosis, histological grade, treatment) variables.

RESULTS:

Not believing in the curability of cancer increased the risk of all-cause mortality (hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.06-2.39) and CRC-specific mortality (HR, 1.65; 95% CI, 0.90-3.03; P = .10). These multivariate estimates were not altered by additional adjustment for insurance coverage, obesity, smoking, alcohol consumption, or comorbidity. Furthermore, the association between perceived curability and survival did not vary significantly by key sociodemographic or biomedical factors. Other beliefs were not associated with survival.

CONCLUSIONS:

Among a racially diverse cohort of men and women with CRC, believing in the curability of cancer was independently associated with survival over a 15-year period. Confirmation of the role of cancer-specific beliefs on survival and study of the potential biobehavioral mechanisms is needed. Findings may inform the design of interventions for cancer survivors. Cancer 2009;115(18 suppl):4270–82. © 2009 American Cancer Society.

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