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dc.contributor.authorLyratzopoulos, Georgiosen
dc.contributor.authorLiu, Michael Pang-Hsiangen
dc.contributor.authorAbel, Garyen
dc.contributor.authorWardle, Janeen
dc.contributor.authorKeating, Nancy Len
dc.date.accessioned2015-04-21T13:22:57Z
dc.date.available2015-04-21T13:22:57Z
dc.date.issued2015-02-03en
dc.identifier.citationCancer Epidemiology, Biomarkers & Prevention 2015, 24, 720. DOI: 10.1158/1055-9965.EPI-14-0969en
dc.identifier.issn1055-9965
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/247405
dc.description.abstractBackground: Fatalistic beliefs may be implicated in longer help-seeking intervals, and consequently, greater risk of advanced stage at cancer diagnosis. Methods: We examined associations between fatalism and stage at diagnosis in a population-based cohort of 4,319 U.S. patients with newly-diagnosed lung or colorectal cancer participating in the Cancer Care Outcomes and Research Surveillance (CanCORS) study. Fatalistic beliefs were assessed with an established measure. A fatalism score (range 4-16) was created by summing Likert-scale responses to four items. Cancer stage at diagnosis was abstracted from medical records by trained staff. Logistic regression was used to assess the association between fatalism score and advanced stage at diagnosis (IV vs I-III), adjusting for socio-demographic and clinical characteristics. Results: Overall, 917 (21%) patients had stage IV cancers (lung: 28%, colorectal: 16%). The mean fatalism score was 10.7 (median=11, inter-quartile range 9-12). In adjusted analyses, a higher fatalism score was associated with greater odds of stage IV diagnosis (odds ratio per unit increase in fatalism=1.05, 95% confidence interval 1.02-1.08, p=0.003). Patients with the highest fatalism score had an adjusted 8.9% higher frequency of stage IV diagnosis compared with patients with the lowest score (25.4% vs. 16.5%). Conclusions: In this large and socioeconomically, geographically and ethnically diverse population of patients with lung and colorectal cancer, fatalistic beliefs were associated with higher risk of advanced stage at diagnosis. Longitudinal studies are needed to confirm causation. Impact: These findings support the value of incorporating information about the curability of early-stage cancers in public education campaigns.
dc.description.sponsorshipThis work of the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium was supported by grants from the National Cancer Institute (NCI) to the Statistical Coordinating Center (U01 CA093344) and the NCI-supported Primary Data Collection and Research Centers (Dana Farber Cancer Institute/Cancer Research Network U01 CA093332, Harvard Medical School/Northern California Cancer Center U01 CA093324, RAND/UCLA U01 CA093348, University of Alabama at Birmingham U01 CA093329, University of Iowa U01 CA093339, University of North Carolina U01 CA093326) and by a Department of Veteran’s Affairs grant to the Durham VA Medical Center CRS 02-164. Dr. Keating’s effort was also supported by 1R01CA164021-01A1 and K24CA18151 from the NCI. Professor Wardle’s contribution is supported by Cancer Research UK Programme grant C1418/A14134. Dr. Lyratzopoulos is supported by a Post-Doctoral Fellowship award by the (UK’s) National Institute for Health Research (PDF-2011-04-047) 2012-2014 and a Cancer Research UK Clinician Scientist Fellowship award (A18180) from 2015. The views expressed in this publication are those of the authors and not necessarily those of the National Cancer Institute, the Department of Veterans Affairs, the NHS (National Health Service), the National Institute for Health Research (NIHR), the (UK) Department of Health, or any other funder.
dc.languageEnglishen
dc.language.isoenen
dc.publisherAmerican Association for Cancer Research
dc.subjectStageen
dc.subjectDiagnosisen
dc.subjectFatalismen
dc.subjectColorectalen
dc.subjectLungen
dc.titleThe association between fatalistic beliefs and late stage at diagnosis of lung and colorectal canceren
dc.typeArticle
dc.description.versionThis is the accepted manuscript. The final version is available at http://cebp.aacrjournals.org/content/24/4/720.long.en
prism.number720en
prism.publicationDate2015en
prism.publicationNameCancer Epidemiology, Biomarkers & Preventionen
prism.volume24en
dc.rioxxterms.funderCRUK
dc.rioxxterms.funderNIHR
dc.rioxxterms.projectidA18180
dc.rioxxterms.projectidC1418/A14134
dc.rioxxterms.projectidPDF-2011-04-047
dcterms.dateAccepted2015-01-07en
rioxxterms.versionofrecord10.1158/1055-9965.EPI-14-0969en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2015-02-03en
dc.contributor.orcidLyratzopoulos, Georgios [0000-0002-2873-7421]
dc.identifier.eissn1538-7755
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idTCC (PDF-2011-04-047)
rioxxterms.freetoread.startdate2016-02-03


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