| Titre : | Influence of psychological response on survival in breast cancer : a population-based cohort study. (1999) |
| Auteurs : | M. WATSON ; J.M. BLISS ; J. DAVIDSON ; S. GREER ; J.S. HAVILAND ; Institute of Cancer Research. Sutton. GBR |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 354, n° 9187, 1999) |
| Pagination : | 1331-1336 |
| Langues: | Anglais |
| Mots-clés : | Cancer ; Sein ; Psychologie ; Epidémiologie ; Pronostic ; Survie ; Homme ; Femme ; Etude comparée ; Royaume Uni ; Europe ; Glande mammaire [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST 02z7R0x6. Diffusion soumise à autorisation]. Background The psychological response to breast cancer, such as a fighting spirit or an attitude of helplessness and hopelessness toward the disease, has been suggested as a prognostic factor with an influence on survival. We have investigated the effect of psychological response on disease outcome in a large cohort of women with early-stage breast cancer. Methods 578 women with early-stage breast cancer were enrolled in a prospective survival study. Psychological response was measured by the mental adjustment to cancer (MAC) scale, the Courtauld emotional control (CEC) scale, and the hospital anxiety and depression (HAD) scale 4-12 weeks and 12 months after diagnosis. The women were followed up for at least 5 years. Cox's proportional-hazards regression was used to obtain the hazard ratios for the measures of psychological response, with adjustment for known clinical factors associated with survival. Findings At 5 years, 395 women were alive and without relapse, 50 were alive with relapse, and 133 had died. There was a significantly increased risk of death from all causes by 5 years in women with a high score on the HAD scale category of depression (hazard ratio 3.59 [95% Cl 1.39-9.24]). There was a significantly increased risk of relapse or death at 5 years in women with high scores on the helplessness and hopelessness category of the MAC scale compared with those with a low score in this category (1.55 [1.07-2.25]). (...) |
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