A prospective study on educational level and adaptation to cancer, within one year after the diagnosis, in an older population

Abstract

Socio‐economic status (SES) has often been associated with health disparities and mortality in cancer patients, yet systematic research into the role of SES in the course of the disease is lacking. This prospective study intends to examine the role of SES (i.e. educational level in this study) in psychological and physical adaptation to cancer. Ninety‐nine cancer patients were followed from a community‐based survey. Pre‐ and post‐morbid data on patients' quality of life (QoL) were available. Adaptation was defined by looking at the level and pattern of scores on QoL scales from pre‐ to post‐disease assessments. Results show some non‐significant trends that more high‐educated patients managed to adapt completely to cancer in relation to role and physical functioning when compared with low‐educated participants. Furthermore, the greater part of high‐educated patients who completely adapted in physical functioning achieved this result more rapidly without an initial deterioration. Unexpectedly, these differences were not significant when tested in a regression model. Hence, although there are some indications for differences in adaptation to role and physical functioning between educational groups, we did not find any evidence that proved such a relation. For the group as a whole, it is very interesting to see that based on our operationalization of adaptation, only a small percentage of patients deteriorated from pre‐ to post‐disease assessments. Copyright © 2007 John Wiley & Sons, Ltd.

Health-related quality of life in lung cancer patients in Serbia: correlation with socio-economic and clinical parameters

“…The HRQoL study of 129 lung cancer patients conducted by Montazeri et al also found that patients of lower socio-economic status showed poorer HRQoL at baseline assessment, but at follow-up assessment there was no clear trend, suggesting that patients from different socio-economic backgrounds responded to treatment similarly (Montazeri et al 2003). Two recent studies conducted in the Netherlands and United Kingdom (samples of mixed-site cancer patients) have confirmed those results: there was an association between socio-economic indicators (education level, car-ownership, homeownership) and poorer HRQoL immediately after diagnosis, with a lack of association at follow-up (Barbareschi et al 2008;Simon & Wardle 2008). There could be a few possible explanations for our contradictory results.…”

“…Additionally, unemployed participants had significantly better HRQoL across a broad spectrum of health domains and significantly lower symptom distress. Two recent studies conducted in the Netherlands and United Kingdom (samples of mixed-site cancer patients) have confirmed those results: there was an association between socio-economic indicators (education level, car-ownership, homeownership) and poorer HRQoL immediately after diagnosis, with a lack of association at follow-up (Barbareschi et al 2008;Simon & Wardle 2008). Sarna L. found that low income was a predictor, a poorer HRQoL in a diverse sample of women with lung cancer (Sarna 1993).…”

Psychological well−being in advanced NSCLC patients in Serbia: impact of sociodemographic and clinical factors

“…In the study conducted by Uchitomi et al among 212 lung cancer patients treated by curative resection, less well educated patients were at higher risk of depression [38]. One small study in Netherlands (n=99, mixed-site cancer patients) indicated that individuals with higher level of education had better emotional and physical wellbeing before their cancer diagnosis, but differences in emotional wellbeing disappeared at 2, 6 and 12 months post-diagnosis [39]. In contrast, in one previous study, when education was used as an indicator of socioeconomic status, higher education was found to be independent predictor of worse quality of life following treatment in prostate cancer patients [40].…”

Exploring the relationship between physical well‐being and healthy lifestyle changes among European‐ and Latina‐American breast and cervical cancer survivors

“…Physical symptoms are among the most burdensome and persistent cancer sequelae including fatigue 6, 7, pain 8, lymphedema 9–11, menopausal symptoms 12–16, and sleep disturbance 17–19. Among cancer survivors, physical well‐being differs by medical characteristics as well as socio‐demographic characteristics including age 7, 8, 20–23, income 24, 25, education 21, 26, and ethnicity 27. One study found that older cancer survivors reported poorer physical quality of life outcomes 23.…”

“…One study found that older cancer survivors reported poorer physical quality of life outcomes 23. Another study demonstrated that individuals with higher education and wealth enjoyed better physical well‐being 24. Moreover, ethnic minority survivors are more likely to report unfavorable physical well‐being outcomes compared with European‐Americans 28–30.…”