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Changes in health and wellbeing in the years leading up to a cancer diagnosis: a prospective cohort study

Jackson, SE; Williams, K; Beeken, R; Steptoe, A; (2019) Changes in health and wellbeing in the years leading up to a cancer diagnosis: a prospective cohort study. Cancer Prevention Research , 12 (2) pp. 79-87. 10.1158/1940-6207.CAPR-18-0277. Green open access

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Abstract

Emerging evidence suggests cancer survivors suffer impairments in health and wellbeing that predate their diagnosis. This study prospectively examined changes from 4 to 6 years prediagnosis to 0 to 2 years postdiagnosis. Data were from 477 cancer survivors and 5,451 cancer-free comparisons participating in the English Longitudinal Study of Ageing. We examined group-by-time interactions for self-rated health, quality of life (QoL), depression, life satisfaction and impairments in mobility, activities of daily living (ADL), and instrumental ADLs (IADL). All health and wellbeing markers worsened over time in both groups. A greater decline in cancer survivors’ self-rated health was evident as early as 2 to 4 years prediagnosis (P < 0.001). Around diagnosis, there were greater declines in IADL impairment (P < 0.001), QoL (P < 0.001), and depression (P < 0.001) in cancer survivors than in controls. Mobility and ADL impairments were consistently more prevalent among cancer survivors (P < 0.001), and life satisfaction was consistently lower (P = 0.004), but the rate of change over time did not differ significantly between groups. These results suggest there may be early signs of deterioration in perceived health that precede development of symptoms leading to cancer diagnosis by many years. Some of the impaired wellbeing in cancer patients may be long-standing, while other changes are more acute and may require targeted support following diagnosis.

Type: Article
Title: Changes in health and wellbeing in the years leading up to a cancer diagnosis: a prospective cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1158/1940-6207.CAPR-18-0277
Publisher version: https://doi.org/10.1158/1940-6207.CAPR-18-0277
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10064534
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