Cancer and Stress: The Effect of a Cancer Diagnosis on Utilization and Outcomes

Principal Investigator: Maureen Smith

Advances in cancer detection and treatment have shifted cancer from a short-term, fatal disease, to a chronic condition necessitating a focus on longer-term outcomes. One-third to one-half of cancer patients experience lasting psychological distress (i.e. depression and anxiety). Identifying older cancer patients at risk of an elevated stress response at the time of diagnosis is critical in order to maximize high quality care. In this project, we aim to estimate the nature, magnitude, and duration of the stress response pre- to post-cancer diagnosis and determine individual and situational factors associated with an elevated response, while simultaneously assessing its health care utilization and health outcome consequences. We will accomplish these aims with the use of data from the Wisconsin Longitudinal Study (WLS), a long-term study of a one-third random sample of men and women who graduated from Wisconsin high schools in 1957 and a randomly selected sibling. Eleven percent of WLS respondents are cancer survivors. The analytic plan estimates causal effects by capitalizing on the WLS study design (longitudinal data, availability of a non-cancer control group) and linkages to the Wisconsin Tumor Registry and Medicare databases. The results from our investigation will have important implications for patient care, including reducing patient suffering and improving quality of life while reducing excess health care utilization and its commensurate costs.

Funded by NIH/NCI