TY - JOUR
T1 - Perceived diagnostic delay and cancer-related distress
T2 - A cross-sectional study of patients with colorectal cancer
AU - Miles, Anne
AU - Mcclements, Paula L.
AU - Steele, Robert J. C.
AU - Redeker, Claudia
AU - Sevdalis, Nick
AU - Wardle, Jane
N1 - : Authors A. Miles, R.J.C. Steele, N. Sevdalis and J. Wardle received a grant from
the Bowel Disease Research Foundation to fund this project. N. Sevdalis’ research was funded by the
This is the peer reviewed version of the following article: 'Perceived diagnostic delay and cancer-related distress:
a cross sectional study of patients with colorectal cancer' which has been published in final form at 10.1002/
pon.4093. This article may be used for non-commercial purposes in accordance with Wiley Terms and
Conditions for Self-Archiving
2
UK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health
Research and Care South London at King's College Hospital NHS Foundation Trust. The views
expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department
of Health. J. Wardle is supported by Cancer Research UK. The study funder played no role in the
study design; the collection, analysis and interpretation of data; the writing of the report; or in the
decision to submit the article for publication
PY - 2017/1
Y1 - 2017/1
N2 - Objective: This study aimed to examine the effect of perceived diagnostic delay on cancer-related distress and determine whether fear of cancer-recurrence and quality of life mediate this relationship. Methods: Cross-sectional study in which 311 colorectal cancer (CRC) survivors in Scotland completed a survey, which included questions on cancer-related distress (IES-R), perceived diagnostic delay, quality of life (trial outcome index of the FACT-C: FACT-C TOI) and fear of cancer recurrence. Fifteen patients withheld consent to data matching with medical records, leaving a sample size of 296. Participants were an average of 69 years old (range 56 to 81) and between 3.5 and 12 years post-diagnosis. Multiple regressions were used to test predictors of distress and regression and bootstrapping to test for mediation. Results: Perceived diagnostic delay was correlated with higher cancer-related distress, while objective markers of diagnostic delay (disease stage at diagnosis and treatment received) were not. Some of the relationship between perceived diagnostic delay and cancer-related distress was mediated by quality of life, but not by fear of cancer recurrence. Conclusions: Perceived diagnostic delay was associated with higher cancer-related distress among CRC survivors. While poorer quality of life partly explained such associations, fear of cancer recurrence, stage at diagnosis and treatment did not. The exact features of diagnostic delay that are associated with cancer-related distress remain unclear. Future research should examine the experiences patients go through prior to diagnosis that may increase distress, in an effort to improve our understanding of the factors affecting emotional wellbeing among CRC survivors.
AB - Objective: This study aimed to examine the effect of perceived diagnostic delay on cancer-related distress and determine whether fear of cancer-recurrence and quality of life mediate this relationship. Methods: Cross-sectional study in which 311 colorectal cancer (CRC) survivors in Scotland completed a survey, which included questions on cancer-related distress (IES-R), perceived diagnostic delay, quality of life (trial outcome index of the FACT-C: FACT-C TOI) and fear of cancer recurrence. Fifteen patients withheld consent to data matching with medical records, leaving a sample size of 296. Participants were an average of 69 years old (range 56 to 81) and between 3.5 and 12 years post-diagnosis. Multiple regressions were used to test predictors of distress and regression and bootstrapping to test for mediation. Results: Perceived diagnostic delay was correlated with higher cancer-related distress, while objective markers of diagnostic delay (disease stage at diagnosis and treatment received) were not. Some of the relationship between perceived diagnostic delay and cancer-related distress was mediated by quality of life, but not by fear of cancer recurrence. Conclusions: Perceived diagnostic delay was associated with higher cancer-related distress among CRC survivors. While poorer quality of life partly explained such associations, fear of cancer recurrence, stage at diagnosis and treatment did not. The exact features of diagnostic delay that are associated with cancer-related distress remain unclear. Future research should examine the experiences patients go through prior to diagnosis that may increase distress, in an effort to improve our understanding of the factors affecting emotional wellbeing among CRC survivors.
UR - http://www.scopus.com/inward/record.url?scp=84958259563&partnerID=8YFLogxK
U2 - 10.1002/pon.4093
DO - 10.1002/pon.4093
M3 - Article
C2 - 26868950
AN - SCOPUS:84958259563
SN - 1057-9249
VL - 26
SP - 29
EP - 36
JO - Psycho-Oncology
JF - Psycho-Oncology
IS - 1
ER -
