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Age and Gender Differences in the Association between Serious Psychological Distress and Cancer: Findings from the 2003, 2005, and 2007 Health Information National Trends Surveys (HINTS)

Kesheng Wang, Xuefeng Liu, Liang Wang


Background: Little is known about the association of serious psychological distress (SPD) with cancer.

Aims: This study examined the association between SPD and cancer, and tested whether such association differed by age and gender.

Methods: Data came from the 2003, 2005, and 2007 Health Information National Trends Surveys (HINTS) (2,637 cancer cases and 16,581 controls). Weighted univariate and multiple logistic regression analyses were used to estimate the odds ratios (ORs) with 95% confidence intervals (CIs).

Results: The overall prevalence of SPD was 6.7% (5.4% for males and 7.9 % for females; 7.1% for cancers and 6.4% for controls). The prevalence of SPD decreased with age (7.8%, 5.8% and 3.9% for age groups 18-49, 50-64 and 65+ years, respectively). After adjusting for other factors, being female, elder (65+ years), SPD, and poor general health were positively associated with cancer (p<0.05). Gender-stratified analyses showed that SPD was associated with cancer only in women. Stratified by age groups, SPD and obesity were associated with cancer only in elderly.

Conclusions: Older age, being female, SPD and poor general health were associated with increased likelihood of cancer. Stratified by age groups and gender, SPD was significantly associated with cancer in women and elder group. It is important to develop effective strategies to manage SPD among patients with cancer, especially in women and elder adults.


Cancer; serious psychological distress; age difference; gender difference


Hoffman KE, McCarthy EP, Recklitis CJ, Ng AK. Psychological distress in long-term survivors of adult-onset cancer: results from a national survey. Archives of Internal Medicine. 2009, 169:1274-1281

Bower JE, Ganz PA, Desmond KA, et al. Fatigue in long-term breast carcinoma survivors: A longitudinal investigation. Cancer. 2006, 106:751-758

Feuerstein M, Bruns GL, Pollman C, Todd BL. Management of unexplained symptoms in survivors of cancer. Journal of Oncology Practice. 2010, 6:308-311

Helgeson VS, Tomich PL. Surviving cancer: A comparison of 5-year disease-free breast cancer survivors with healthy women. Psychooncology. 2005, 14:307-317

Kadan-Lottick NS, Vanderwerker LC, Block SD, Zhang B, Prigerson HG. Psychiatric disorders and mental health service use in patients with advanced cancer. Cancer. 2005, 104:2872-2881

Gordon LG, Beesley VL, Scuffham PA. Evidence on the economic value of psychosocial interventions to alleviate anxiety and depression among cancer survivors: a systematic review. Asia-Pacific Journal of Clinical Oncology. 2011, 7:96-105

Jacobsen PB, Jim HS. Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA: A Cancer Journal for Clinicians. 2008, 58:214-30

Strong V, Waters R, Hibberd C, Rush R, Cargill A, Storey D, Walker J, Wall L, Fallon M, Sharpe M. Psychological distress in cancer patients: the Edinburgh Cancer Centre symptom study. British Journal of Cancer. 2007, 96:868-874.

Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psycho-Oncology. 2001, 10:19-28

Bjordal K, Kaasa S. Psychological distress in head and neck cancer patients 7-11 years after curative treatment. British Journal of Cancer. 1995, 71:592-597

Kruk J, Aboul-Enein HY. Psychological stress and the risk of breast cancer: a case-control study. Cancer Detection and Prevention. 2004, 28:399-408

Conti CM, Maccauro G, Fulcheri M. Psychological stress and cancer. International Journal of Immunopathology and Pharmacology. 2011, 24:1-5

Risberg T, Sørbye SW, Norum J, Wist EA. Diagnostic delay causes more psychological distress in female than in male cancer patients. Anticancer Research. 1996, 16:995-999

Shih M, Hootman JM, Strine TW, Chapman DP, Brady TJ. Serious psychological distress in U.S. adults with arthritis. Journal of General Internal Medicine. 2006, 21:1160-1166

Shih M, Simon PA. Health-related quality of life among adults with serious psychological distress and chronic medical conditions. Quality of Life Research. 2008, 17:521-528

Zhao G, Li C, Li J, Balluz LS. Physical activity, psychological distress, and receipt of mental healthcare services among cancer survivors. J Cancer Surviv. 2013;7:131-139

Nelson DE, Kreps GL, Hesse BW, et al. The Health Information National Trends Survey (HINTS): development, design, and dissemination. Journal of Community Health. 2004, 9:443-460

Chou WY, Liu B, Post S, Hesse B. Health-related Internet use among cancer survivors: Data from the Health Information National Trends Survey, 2003-2008 . Journal of Cancer Survivorship. 2011, 5: 263-270

Home page. Health Information National Trends Survey (HINTS).

Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine. 2002, 32:959-976

Kessler RCP, Barker PRM, Colpe LJP, et al. Screening for serious mental illness in the general population. Archives of General Psychiatry. 2003, 60:184-189

Baggaley RF, Ganaba R, Filippi V, et al. Detecting depression after pregnancy: the validity of the K10 and K6 in Burkina Faso. Tropical Medicine & International Health. 2007, 12:1225-1229

Swartz JA, Lurigio AJ. Screening for serious mental illness in populations with co-occurring substance use disorders: Performance of the K6 scale. Journal of Substance Abuse Treatment. 2006, 31:287-296

Denduluri N, Ershler WB. Aging biology and cancer. Semin Oncol. 2004, 31:137-148

Avis NE, Deimling GT. Cancer survivorship and aging. Cancer. 2008, 113(12 Suppl):3519-3529

Anisimov VN, Sikora E, Pawelec G. Relationships between cancer and aging: a multilevel approach. Biogerontology. 2009, 10:323-338

Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009, 27:2758-2765

de Magalhães JP. How ageing processes influence cancer. Nat Rev Cancer. 2013, 13:357-365

Hagedoorn M, Sanderman R, Bolks HN, Tuinstra J, Coyne JC. Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects. Psychological Bulletin. 2008, 134:1-30

Härter M, Reuter K, Aschenbrenner A et al. Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment. European Journal of Cancer. 2001, 37:1385-1393

KimSJ, Rha SY, Song SK et al. Prevalence and associated factors of psychological distress among Korean cancer patients. General Hospital Psychiatry. 2011, 33:246-252

McCaughan E, Prue G, Parahoo K. A systematic review of quantitative studies reporting selected patient experienced outcomes, with a specific focus on gender differences in people with colorectal cancer. European Journal of Oncology Nursing. 2009, 13:376-385

Ernst J, Götze H, Krauel K, Romer G, Bergelt C, Flechtner HH, Herzog W, Lehmkuhl U, Keller M, Brähler E, von Klitzing K. Psychological distress in cancer patients with underage children: gender-specific differences. Psychooncology. 2013, 22:823-828

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