Abstract
The aim of this study was to determine the issues patients worry about when making decisions about cancer treatment. A total of 5,044 colorectal and lung cancer patients from the Cancer Care Outcomes Research and Surveillance Consortium reported their level of worry about (1) treatment side effects, (2) treatment costs, (3) time away from family, (4) time away from work, and (5) transportation to treatment sites. Using multivariable logistic regression, we evaluated the association of sociodemographic, clinical, and psychosocial variables with worry. Overall, 75 % of patients worried about side effects of treatments; 40 %, the cost of treatment; 50 %, time away from family; 52 %, time away from work; and 22 %, about transportation. In multivariable analyses, across all worry domains, older patients had lower odds of reporting worry (p values < 0.001). Patients who perceived less than excellent quality of care, self-assessed their health as less than excellent, and those with a higher cancer stage were more likely to report worry. Asian patients were more likely to report worry than Whites about the cost of treatment and transportation, and relative to Whites, Hispanics were more likely to report worry about transportation (p values < 0.05). Black patients were less likely to report worry about time away from work. Patients worry about issues beyond treatment side effects when making treatment decisions. The pattern of worry varies along sociodemographic, clinical, and psychosocial factors, including race and ethnicity. Understanding the source of patient worry and identifying interventions to alleviate worry are important to delivering patient-centered cancer care.
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Acknowledgments
We would like to thank Dr. Don Hill for his review on this manuscript and Shari Lamona for administrative assistance.
Source of support
The CanCORS consortium was supported by grants from the National Cancer Institute (NCI) to the Statistical Coordinating Center (U01 CA093344) and the NCI-supported Primary Data Collection and Research Centers (Dana-Farber Cancer Institute/Cancer Research Network U01 CA093332, Harvard Medical School/Northern California Cancer Center U01 CA093324, RAND/UCLA U01 CA093348, University of Alabama at Birmingham U01 CA093329, University of Iowa U01 CA.093339, University of North Carolina U01 CA 093326) and by a Department of Veterans Affairs grant to the Durham VA Medical Center CRS 02-164. Morehouse School of Medicine/Tuskegee University/University of Alabama Cancer Center Partnership U54CA118948, University of Alabama at Birmingham P30 AG031054.
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This paper was presented in part at the 32nd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine, Washington, DC (2011).
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Martin, M.Y., Fouad, M.N., Oster, R.A. et al. What do cancer patients worry about when making decisions about treatment? Variation across racial/ethnic groups. Support Care Cancer 22, 233–244 (2014). https://doi.org/10.1007/s00520-013-1958-5
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DOI: https://doi.org/10.1007/s00520-013-1958-5