Skip to main content
Top
Published in: Journal of Cancer Survivorship 5/2016

Open Access 01-10-2016

Illness perceptions are associated with mortality among 1552 colorectal cancer survivors: a study from the population-based PROFILES registry

Authors: Melissa S. Y. Thong, Adrian A. Kaptein, Pauline A. J. Vissers, Gerard Vreugdenhil, Lonneke V. van de Poll-Franse

Published in: Journal of Cancer Survivorship | Issue 5/2016

Login to get access

Abstract

Purpose

Cancer survivors construct perceptions of illness as a (mal)adaptive mechanism. These perceptions motivate/drive subsequent self-management behaviors toward symptoms and treatment that influence health outcomes. Negative illness perceptions have been associated with increased mortality in other chronically ill groups. However, this association is under-researched in cancer survivors. We aimed to explore the association between illness perceptions and mortality in stage I–III progression-free colorectal cancer (CRC) survivors.

Methods

We used data from the population-based Patient Reported Outcomes Following Initial treatment and Long Term Evaluation of Survivorship (PROFILES) registry of two CRC survivorship studies conducted in 2009 and 2010. We accessed clinical data from the Netherlands Cancer Registry, and mortality data from municipal personal records database. Follow-up was until 31 December 2014. Survivors (n = 1552) completed the Brief Illness Perception Questionnaire. Cox proportional hazard models estimated the association between illness perceptions and mortality.

Results

Negative illness perceptions on consequences (adjusted hazard ratio (HRadj) 1.60, 95 % confidence interval (CI) 1.14–2.25) and emotion (HRadj 1.65, 95 % CI 1.18–2.31) were associated with higher mortality, after adjusting for demographic, clinical, and lifestyle factors. Smoking and inadequate physical activity were independently associated with mortality for all Brief Illness Perception Questionnaire (BIPQ) dimensions.

Conclusions

Survivors’ perceptions of their illness are important as these perceptions may influence health outcomes during survivorship period. Clinical practice needs to identify and address maladaptive illness perceptions to support more adaptive self-management behaviors and enhance survivorship.

Implications for cancer survivors

Cancer survivors may benefit from interventions that address potentially maladaptive perceptions and encourage more adaptive self-management behaviors.
Literature
1.
go back to reference Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, editors. The self-regulation of health and illness behaviour. London: Routledge; 2003. p. 42–65. Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, editors. The self-regulation of health and illness behaviour. London: Routledge; 2003. p. 42–65.
2.
go back to reference Scott SE. Symptom perception and help seeking. In: French D, Vedhara K, Kaptein AA, et al., editors. Health Psychology. 2nd ed. Chichester: BPS Blackwell Publishing; 2010. p. 162–74. Scott SE. Symptom perception and help seeking. In: French D, Vedhara K, Kaptein AA, et al., editors. Health Psychology. 2nd ed. Chichester: BPS Blackwell Publishing; 2010. p. 162–74.
3.
go back to reference Stallings DT: Illness perceptions and health behaviors of Black women. J Cardiovasc Nurs. 2015. Stallings DT: Illness perceptions and health behaviors of Black women. J Cardiovasc Nurs. 2015.
4.
go back to reference Bonsaksen T, Lerdal A, Fagermoen MS. Factors associated with self-efficacy in persons with chronic illness. Scand J Psych. 2012;53:333–9.CrossRef Bonsaksen T, Lerdal A, Fagermoen MS. Factors associated with self-efficacy in persons with chronic illness. Scand J Psych. 2012;53:333–9.CrossRef
5.
go back to reference Tiemensma J, Andela CD, Pereira AM, et al. Patients with adrenal insufficiency hate their medication: concerns and stronger beliefs about the necessity of hydrocortisone intake are associated with more negative illness perceptions. J Clin Endocrinol Metab. 2014;99:3668–76.CrossRefPubMed Tiemensma J, Andela CD, Pereira AM, et al. Patients with adrenal insufficiency hate their medication: concerns and stronger beliefs about the necessity of hydrocortisone intake are associated with more negative illness perceptions. J Clin Endocrinol Metab. 2014;99:3668–76.CrossRefPubMed
6.
go back to reference Wearden A, Peters S. Therapeutic techniques for interventions based on Leventhal’s common sense model. Br J Health Psychol. 2008;13:189–93.CrossRefPubMed Wearden A, Peters S. Therapeutic techniques for interventions based on Leventhal’s common sense model. Br J Health Psychol. 2008;13:189–93.CrossRefPubMed
7.
go back to reference Foster C, Breckons M, Cotterell P, et al. Cancer survivors’ self-efficacy to self-manage in the year following primary treatment. J Cancer Surviv. 2015;9:11–9.CrossRefPubMed Foster C, Breckons M, Cotterell P, et al. Cancer survivors’ self-efficacy to self-manage in the year following primary treatment. J Cancer Surviv. 2015;9:11–9.CrossRefPubMed
8.
go back to reference Hopman P, Rijken M. Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psychooncology. 2015;24:11–8.CrossRefPubMed Hopman P, Rijken M. Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psychooncology. 2015;24:11–8.CrossRefPubMed
9.
go back to reference Llewellyn CD, McGurk M, Weinman J. Illness and treatment beliefs in head and neck cancer: is Leventhal’s common sense model a useful framework for determining changes in outcomes over time? J Psychosom Res. 2007;63:17–26.CrossRefPubMed Llewellyn CD, McGurk M, Weinman J. Illness and treatment beliefs in head and neck cancer: is Leventhal’s common sense model a useful framework for determining changes in outcomes over time? J Psychosom Res. 2007;63:17–26.CrossRefPubMed
10.
go back to reference Iskandarsyah A, de Klerk C, Suardi DR, et al. Consulting a traditional healer and negative illness perceptions are associated with non-adherence to treatment in Indonesian women with breast cancer. Psychooncology. 2014;23:1118–24.CrossRefPubMed Iskandarsyah A, de Klerk C, Suardi DR, et al. Consulting a traditional healer and negative illness perceptions are associated with non-adherence to treatment in Indonesian women with breast cancer. Psychooncology. 2014;23:1118–24.CrossRefPubMed
11.
go back to reference Thune-Boyle IC, Myers LB, Newman SP. The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment. Behav Med. 2006;32:19–29.CrossRefPubMed Thune-Boyle IC, Myers LB, Newman SP. The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment. Behav Med. 2006;32:19–29.CrossRefPubMed
12.
go back to reference Gray N, Hall S, Browne S, et al. Predictors of anxiety and depression in people with colorectal cancer. Support Care Cancer. 2014;22:307–14.CrossRefPubMed Gray N, Hall S, Browne S, et al. Predictors of anxiety and depression in people with colorectal cancer. Support Care Cancer. 2014;22:307–14.CrossRefPubMed
13.
go back to reference Ashley L, Marti J, Jones H, et al. Illness perceptions within 6 months of cancer diagnosis are an independent prospective predictor of health-related quality of life 15 months post-diagnosis. Psychooncology. 2015;24:1463–70.CrossRefPubMed Ashley L, Marti J, Jones H, et al. Illness perceptions within 6 months of cancer diagnosis are an independent prospective predictor of health-related quality of life 15 months post-diagnosis. Psychooncology. 2015;24:1463–70.CrossRefPubMed
14.
go back to reference Parfeni M, Nistor I, Covic A. A systematic review regarding the association of illness perception and survival among end-stage renal disease patients. Nephrol Dial Transplant. 2013;28:2407–14.CrossRefPubMed Parfeni M, Nistor I, Covic A. A systematic review regarding the association of illness perception and survival among end-stage renal disease patients. Nephrol Dial Transplant. 2013;28:2407–14.CrossRefPubMed
15.
go back to reference Crawshaw J, Rimington H, Weinman J, et al.: Illness perception profiles and their association with 10-Year survival following cardiac valve replacement. Ann Behav Med. 2015: 1–7. Crawshaw J, Rimington H, Weinman J, et al.: Illness perception profiles and their association with 10-Year survival following cardiac valve replacement. Ann Behav Med. 2015: 1–7.
16.
go back to reference Soler-Vila H, Kasl SV, Jones BA. Cancer-specific beliefs and survival: a population-based study of African-American and White breast cancer patients. Cancer Causes Control. 2005;16:105–14.CrossRefPubMed Soler-Vila H, Kasl SV, Jones BA. Cancer-specific beliefs and survival: a population-based study of African-American and White breast cancer patients. Cancer Causes Control. 2005;16:105–14.CrossRefPubMed
17.
go back to reference Soler-Vila H, Dubrow R, Franco VI, et al. Cancer-specific beliefs and survival in nonmetastatic colorectal cancer patients. Cancer. 2009;115:4270–82.CrossRefPubMedPubMedCentral Soler-Vila H, Dubrow R, Franco VI, et al. Cancer-specific beliefs and survival in nonmetastatic colorectal cancer patients. Cancer. 2009;115:4270–82.CrossRefPubMedPubMedCentral
18.
go back to reference Karim-Kos HE, de Vries E, Soerjomataram I, et al. Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. Eur J Cancer. 2008;44:1345–89.CrossRefPubMed Karim-Kos HE, de Vries E, Soerjomataram I, et al. Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. Eur J Cancer. 2008;44:1345–89.CrossRefPubMed
19.
go back to reference Elferink MA, van Steenbergen LN, Krijnen P, et al. Marked improvements in survival of patients with rectal cancer in the Netherlands following changes in therapy, 1989–2006. Eur J Cancer. 2010;46:1421–9.CrossRefPubMed Elferink MA, van Steenbergen LN, Krijnen P, et al. Marked improvements in survival of patients with rectal cancer in the Netherlands following changes in therapy, 1989–2006. Eur J Cancer. 2010;46:1421–9.CrossRefPubMed
20.
go back to reference van Steenbergen LN, Lemmens VEPP, Rutten HJT, et al. Increased adjuvant treatment and improved survival in elderly stage III colon cancer patients in The Netherlands. Ann Oncol. 2012;23:2805–11.CrossRefPubMed van Steenbergen LN, Lemmens VEPP, Rutten HJT, et al. Increased adjuvant treatment and improved survival in elderly stage III colon cancer patients in The Netherlands. Ann Oncol. 2012;23:2805–11.CrossRefPubMed
21.
22.
go back to reference Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.CrossRefPubMed Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.CrossRefPubMed
23.
go back to reference Cancer in the Netherlands until 2020. Trends and prognoses. [Kanker in Nederland tot 2020. Trends en prognoses]. Amsterdam, KWF Kankerbestrijding, 2011 Cancer in the Netherlands until 2020. Trends and prognoses. [Kanker in Nederland tot 2020. Trends en prognoses]. Amsterdam, KWF Kankerbestrijding, 2011
24.
go back to reference Ganz PA. Why and how to study the fate of cancer survivors: observations from the clinic and the research laboratory. Eur J Cancer. 2003;39:2136–41.CrossRefPubMed Ganz PA. Why and how to study the fate of cancer survivors: observations from the clinic and the research laboratory. Eur J Cancer. 2003;39:2136–41.CrossRefPubMed
26.
go back to reference Walter V, Jansen L, Hoffmeister M, et al. Smoking and survival of colorectal cancer patients: population-based study from Germany. Int J Cancer. 2015;137:1433–45.CrossRefPubMed Walter V, Jansen L, Hoffmeister M, et al. Smoking and survival of colorectal cancer patients: population-based study from Germany. Int J Cancer. 2015;137:1433–45.CrossRefPubMed
27.
go back to reference Mols F, Denollet J, Kaptein AA, et al. The association between Type D personality and illness perceptions in colorectal cancer survivors: a study from the population-based PROFILES registry. J Psychosom Res. 2012;73:232–9.CrossRefPubMed Mols F, Denollet J, Kaptein AA, et al. The association between Type D personality and illness perceptions in colorectal cancer survivors: a study from the population-based PROFILES registry. J Psychosom Res. 2012;73:232–9.CrossRefPubMed
28.
go back to reference van de Poll-Franse LV, Horevoorts N, Van Eenbergen MC, et al. The Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship registry: scope, rationale and design of an infrastructure for the study of physical and psychosocial outcomes in cancer survivorship cohorts. Eur J Cancer. 2011;47:2188–94.CrossRefPubMed van de Poll-Franse LV, Horevoorts N, Van Eenbergen MC, et al. The Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship registry: scope, rationale and design of an infrastructure for the study of physical and psychosocial outcomes in cancer survivorship cohorts. Eur J Cancer. 2011;47:2188–94.CrossRefPubMed
29.
go back to reference Broadbent E, Petrie KJ, Main J, et al. The Brief Illness Perception Questionnaire. J Psychosom Res. 2006;60:631–7.CrossRefPubMed Broadbent E, Petrie KJ, Main J, et al. The Brief Illness Perception Questionnaire. J Psychosom Res. 2006;60:631–7.CrossRefPubMed
30.
go back to reference Broadbent E, Wilkes C, Koschwanez H, et al.: A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health. 2015: 1–74. Broadbent E, Wilkes C, Koschwanez H, et al.: A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health. 2015: 1–74.
31.
go back to reference Sangha O, Stucki G, Liang MH, et al. The Self-administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003;49:156–63.CrossRefPubMed Sangha O, Stucki G, Liang MH, et al. The Self-administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003;49:156–63.CrossRefPubMed
32.
go back to reference UICC: TNM Atlas Illustrated Guide to the TNM/pTNM Classification of Malignant Tumours, (ed 4th edn., 2nd Revision). Berlin: SpringerVerlag. 1992:141–144. UICC: TNM Atlas Illustrated Guide to the TNM/pTNM Classification of Malignant Tumours, (ed 4th edn., 2nd Revision). Berlin: SpringerVerlag. 1992:141–144.
33.
go back to reference Pols MA, Peeters PH, Ocke MC, et al. Estimation of reproducibility and relative validity of the questions included in the EPIC Physical Activity Questionnaire. Int J Epidemiol. 1997;26 Suppl 1:S181–9.CrossRefPubMed Pols MA, Peeters PH, Ocke MC, et al. Estimation of reproducibility and relative validity of the questions included in the EPIC Physical Activity Questionnaire. Int J Epidemiol. 1997;26 Suppl 1:S181–9.CrossRefPubMed
34.
go back to reference Ainsworth BE, Haskell WL, Leon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993;25:71–80.CrossRefPubMed Ainsworth BE, Haskell WL, Leon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993;25:71–80.CrossRefPubMed
35.
go back to reference Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32:S498–504.CrossRefPubMed Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32:S498–504.CrossRefPubMed
36.
go back to reference van Gestel YR, de Hingh IH, van Herk-Sukel MP, et al. Patterns of metachronous metastases after curative treatment of colorectal cancer. Cancer Epidemiol. 2014;38:448–54.CrossRefPubMed van Gestel YR, de Hingh IH, van Herk-Sukel MP, et al. Patterns of metachronous metastases after curative treatment of colorectal cancer. Cancer Epidemiol. 2014;38:448–54.CrossRefPubMed
37.
go back to reference Husson O, Thong MS, Mols F, et al. Information provision and patient reported outcomes in patients with metastasized colorectal cancer: results from the PROFILES registry. J Palliat Med. 2013;16:281–8.CrossRefPubMedPubMedCentral Husson O, Thong MS, Mols F, et al. Information provision and patient reported outcomes in patients with metastasized colorectal cancer: results from the PROFILES registry. J Palliat Med. 2013;16:281–8.CrossRefPubMedPubMedCentral
38.
go back to reference Frostholm L, Fink P, Christensen KS, et al. The patients’ illness perceptions and the use of primary health care. Psychosom Med. 2005;67:997–1005.CrossRefPubMed Frostholm L, Fink P, Christensen KS, et al. The patients’ illness perceptions and the use of primary health care. Psychosom Med. 2005;67:997–1005.CrossRefPubMed
39.
go back to reference Antoni MH. Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer. Brain Behav Immun. 2013;30(Suppl):S88–98.CrossRefPubMed Antoni MH. Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer. Brain Behav Immun. 2013;30(Suppl):S88–98.CrossRefPubMed
40.
go back to reference Niu C, Eng L, Qiu X, et al. Lifestyle behaviors in elderly cancer survivors: a comparison with middle-age cancer survivors. J Oncol Pract. 2015;11:e450–9.CrossRefPubMed Niu C, Eng L, Qiu X, et al. Lifestyle behaviors in elderly cancer survivors: a comparison with middle-age cancer survivors. J Oncol Pract. 2015;11:e450–9.CrossRefPubMed
41.
go back to reference Fischer MJ, Krol-Warmerdam EM, Ranke GM, et al. Stick Together: a Nordic Walking group intervention for breast cancer survivors. J Psychosoc Oncol. 2015;33:278–96.CrossRefPubMed Fischer MJ, Krol-Warmerdam EM, Ranke GM, et al. Stick Together: a Nordic Walking group intervention for breast cancer survivors. J Psychosoc Oncol. 2015;33:278–96.CrossRefPubMed
42.
go back to reference Fischer MJ, Wiesenhaan ME, Does-den Heijer A, et al. From despair to hope: a longitudinal study of illness perceptions and coping in a psycho-educational group intervention for women with breast cancer. Br J Health Psychol. 2013;18:526–45.CrossRefPubMed Fischer MJ, Wiesenhaan ME, Does-den Heijer A, et al. From despair to hope: a longitudinal study of illness perceptions and coping in a psycho-educational group intervention for women with breast cancer. Br J Health Psychol. 2013;18:526–45.CrossRefPubMed
43.
go back to reference Antoni MH, Lutgendorf SK, Blomberg B, et al. Cognitive-behavioral stress management reverses anxiety-related leukocyte transcriptional dynamics. Biol Psychiatry. 2012;71:366–72.CrossRefPubMed Antoni MH, Lutgendorf SK, Blomberg B, et al. Cognitive-behavioral stress management reverses anxiety-related leukocyte transcriptional dynamics. Biol Psychiatry. 2012;71:366–72.CrossRefPubMed
Metadata
Title
Illness perceptions are associated with mortality among 1552 colorectal cancer survivors: a study from the population-based PROFILES registry
Authors
Melissa S. Y. Thong
Adrian A. Kaptein
Pauline A. J. Vissers
Gerard Vreugdenhil
Lonneke V. van de Poll-Franse
Publication date
01-10-2016
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 5/2016
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-016-0536-5

Other articles of this Issue 5/2016

Journal of Cancer Survivorship 5/2016 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine