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International Journal of Behavioral Medicine

Published in:

01-10-2018

Prevalence and Correlates of Worry About Medical Imaging Radiation Among United States Cancer Survivors

Authors: Jennifer L. Hay, Raymond E. Baser, Joy S. Westerman, Jennifer S. Ford

Published in: International Journal of Behavioral Medicine | Issue 5/2018

Abstract

Purpose

Cancer survivors undergo lifelong surveillance regimens that involve repeated diagnostic medical imaging. As many of these diagnostic tests use ionizing radiation, which may modestly increase cancer risks, they may present a source of worry for survivors. The aims of this paper are to describe cancer survivors’ level of worry about medical imaging radiation (MIR) and to identify patterns of MIR worry across subgroups defined by cancer type, other medical and demographic factors, and physician trust.

Method

This cross-sectional study used the 2012–2013 Health Information National Trends Survey of US adults conducted by the National Cancer Institute. The analysis focused on the 452 respondents identifying as cancer survivors. Weighted logistic regression analysis was used to evaluate factors associated with higher MIR worry (reporting “some” or “a lot” of MIR worry).

Results

Nearly half (42%) of the sample reported higher worry about MIR. Unadjusted and adjusted logistic regressions indicated higher rates of MIR worry among those with lower incomes, those who self-reported poorer health, and those who completed cancer treatment within the past 10 years. Receipt of radiation treatment was associated with higher MIR worry in unadjusted analysis.

Conclusion

Worries about MIR are relatively common among cancer survivors. An accurate assessment of the rates and patterns of worry could aid efforts to improve these individuals’ survivorship care and education.

American Cancer Society. Cancer treatment & survivorship: facts and figures, 2016–2017. Atlanta: Corporate Center: American Cancer Society Inc.; 2016 [cited 2017 March 28]; Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2016-2017.pdf.

Daly C, Urbach DR, Stukel TA, Nathan PC, Deitel W, Paszat LF, et al. Patterns of diagnostic imaging and associated radiation exposure among long-term survivors of young adult cancer: a population-based cohort study. BMC Cancer. 2015;15:612. https://doi.org/10.1186/s12885-015-1578-1. CrossRefPubMedPubMedCentral

Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, et al. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv. 2013;7(3):300–22. https://doi.org/10.1007/s11764-013-0272-z. CrossRefPubMed

McGinty HL, Small BJ, Laronga C, Jacobsen PB. Predictors and patterns of fear of cancer recurrence in breast cancer survivors. Health Psychol. 2016;35(1):1–9. https://doi.org/10.1037/hea0000238.CrossRefPubMed

Thompson CA, Charlson ME, Schenkein E, Wells MT, Furman RR, Elstrom R, Ruan J, Martin P, Leonard JP Surveillance CT scans are a source of anxiety and fear of recurrence in long-term lymphoma survivors. Ann Oncol 2010;21(11):2262–6. https://doi.org/10.1093/annonc/mdq215, 2266.CrossRefPubMedPubMedCentral

Koch L, Bertram H, Eberle A, Holleczek B, Schmid-Hopfner S, Waldmann A, et al. Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the cancer survivorship—a multi-regional population-based study. Psychooncology. 2014;23(5):547–54. https://doi.org/10.1002/pon.3452. CrossRefPubMed

Simonelli LE, Siegel SD, Duffy NM. Fear of cancer recurrence: a theoretical review and its relevance for clinical presentation and management. Psychooncology. 2016;26:1444–54. https://doi.org/10.1002/pon.4168. CrossRefPubMed

Janz NK, Friese CR, Li Y, Graff JJ, Hamilton AS, Hawley ST. Emotional well-being years post-treatment for breast cancer: prospective, multi-ethnic, and population-based analysis. J Cancer Surviv. 2014;8(1):131–42. https://doi.org/10.1007/s11764-013-0309-3. CrossRefPubMed

Kypriotakis G, Vidrine DJ, Francis LE, Rose JH. The longitudinal relationship between quality of life and survival in advanced stage cancer. Psychooncology. 2016;25(2):225–31. https://doi.org/10.1002/pon.3846. CrossRefPubMed

10.

Bresner L, Banach R, Rodin G, Thabane L, Ezzat S, Sawka AM. Cancer-related worry in Canadian thyroid cancer survivors. J Clin Endocrinol Metab. 2015;100(3):977–85. https://doi.org/10.1210/jc.2014-3169. CrossRefPubMed

11.

Waters EA, Liu Y, Schootman M, Jeffe DB. Worry about cancer progression and low perceived social support: implications for quality of life among early-stage breast cancer patients. Ann Behav Med. 2013;45(1):57–68. https://doi.org/10.1007/s12160-012-9406-1.CrossRefPubMed

12.

Wang R, Syed IA, Nathan PC, Barr RD, Rosenberg-Yunger ZR, Klassen AF. Exploring cancer worry in adolescent and young adult survivors of childhood cancers. J Adolesc Young Adult Oncol. 2015;4(4):192–9.CrossRefPubMed

13.

Consedine NS, Magai C, Krivoshekova YS, Ryzewicz L, Neugut AI. Fear, anxiety, worry, and breast cancer screening behavior: a critical review. Cancer Epidemiol Biomark Prev. 2004;13(4):501–10.

14.

Hay JL, Buckley TR, Ostroff JS. The role of cancer worry in cancer screening: a theoretical and empirical review of the literature. Psychooncology. 2005;14(7):517–34. https://doi.org/10.1002/pon.864. CrossRefPubMed

15.

Cameron L, Leventhal EA, Leventhal H. Seeking medical care in response to symptoms and life stress. Psychosom Med. 1995;57(1):37–47.CrossRefPubMed

16.

Diefenbach MA, Leventhal H. The common-sense model of illness representation: theoretical and practical considerations. J Soc Distress Homeless. 1996;5(1):11–38. https://doi.org/10.1007/bf02090456.CrossRef

17.

Leventhal H. Findings and theory in the study of fear communications. In: Berkowitz L (ed). Adv Exp Soc Psychol: Academic Press; 1970. p. 119–86.

18.

Leventhal H, Cameron L. Behavioral theories and the problem of compliance. Patient Educ Couns. 1987;10(2):117–38. https://doi.org/10.1016/0738-3991(87)90093-0.CrossRef

19.

Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q. 1984;11(1):1–47. https://doi.org/10.1177/109019818401100101.CrossRefPubMed

20.

Calnan M. The health belief model and participation in programmes for the early detection of breast cancer: a comparative analysis. Soc Sci Med. 1984;19(8):823–30.CrossRefPubMed

21.

Champion VL. Instrument development for health belief model constructs. ANS Adv Nurs Sci. 1984;6(3):73–85.CrossRefPubMed

22.

Champion VL. Use of the health belief model in determining frequency of breast self-examination. Res Nurs Health. 1985;8(4):373–9.CrossRefPubMed

23.

Champion VL. The relationship of breast self-examination to health belief model variables. Res Nurs Health. 1987;10(6):375–82.CrossRefPubMed

24.

Maiman LA, Becker MH, Kirscht JP, Haefner DP, Drachman RH. Scales for measuring health belief model dimensions: a test of predictive value, internal consistency, and relationships among beliefs. Health Educ Monogr. 1977;5(3):215–30.CrossRefPubMed

25.

Miller AM, Champion VL. Mammography in women > or = 50 years of age. Predisposing and enabling characteristics. Cancer Nurs. 1993;16(4):260–9.CrossRefPubMed

26.

Champion VL. Attitudinal variables related to intention, frequency and proficiency of breast self-examination in women 35 and over. Res Nurs Health. 1988;11(5):283–91.CrossRefPubMed

27.

Hill D, Gardner G, Rassaby J. Factors predisposing women to take precautions against breast and cervix cancer. J Appl Soc Psychol. 1985;15(1):59–79. https://doi.org/10.1111/j.1559-1816.1985.tb00894.x.CrossRef

28.

Vernon SW, Myers RE, Tilley BC. Development and validation of an instrument to measure factors related to colorectal cancer screening adherence. Cancer Epidemiol Biomark Prev. 1997;6(10):825–32.

29.

Robberson MR, Rogers RW. Beyond fear appeals: negative and positive persuasive appeals to health and self-esteem. J Appl Soc Psychol. 1988;18(3):277–87. https://doi.org/10.1111/j.1559-1816.1988.tb00017.x.CrossRef

30.

W Rogers R, Cacioppo J, Petty R. Cognitive and physiological processes in fear appeals and attitude change: a revised theory of protection motivation. 1983. pp. 153–77

31.

Witte K. Putting the fear back into fear appeals: the extended parallel process model. Commun Monogr. 1992;59(4):329–49. https://doi.org/10.1080/03637759209376276.CrossRef

32.

Janis IL, Feshbach S. Effects of fear-arousing communications. J Abnorm Soc Psychol. 1953;48(1):78–92. https://doi.org/10.1037/h0060732.CrossRef

33.

Hay JL, McCaul KD, Magnan RE. Does worry about breast cancer predict screening behaviors? A meta-analysis of the prospective evidence. Prev Med. 2006;42(6):401–8.CrossRefPubMed

34.

Nguyen PK, Wu JC. Radiation exposure from imaging tests: is there an increased cancer risk? Expert Rev Cardiovasc Ther. 2011;9(2):177–83. https://doi.org/10.1586/erc.10.184. CrossRefPubMedPubMedCentral

35.

Vijayvergia N, Shah PC, Denlinger CS. Survivorship in non-small cell lung cancer: challenges faced and steps forward. J Natl Compr Cancer Netw. 2015;13(9):1151–61.CrossRef

36.

Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman J, Chirieac LR, et al. Non-small cell lung cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw. 2017;15(4):504–35.CrossRef

37.

Hollada J, Speier W, Oshiro T, Marzan-McGill R, Ruehm SG, Bassett LW, et al. Patients’ perceptions of radiation exposure associated with mammography. AJR Am J Roentgenol. 2015;205(1):215–21. https://doi.org/10.2214/ajr.14.13650. CrossRefPubMed

38.

Boone JM, Hendee WR, McNitt-Gray MF, Seltzer SE. Radiation exposure from CT scans: how to close our knowledge gaps, monitor and safeguard exposure—proceedings and recommendations of the Radiation Dose Summit, sponsored by NIBIB, February 24-25, 2011. Radiology. 2012;265(2):544–54. https://doi.org/10.1148/radiol.12112201. CrossRefPubMedPubMedCentral

39.

Fletcher JG, Kofler JM, Coburn JA, Bruining DH, McCollough CH. Perspective on radiation risk in CT imaging. Abdom Imaging. 2013;38(1):22–31. https://doi.org/10.1007/s00261-012-9933-z.CrossRefPubMed

40.

Brenner DJ, Shuryak I, Einstein AJ. Impact of reduced patient life expectancy on potential cancer risks from radiologic imaging. Radiology. 2011;261(1):193–8. https://doi.org/10.1148/radiol.11102452. CrossRefPubMed

41.

Zhang Y, Chen Y, Huang H, Sandler J, Dai M, Ma S, et al. Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study. Eur J Cancer Prev. 2015;24(5):439–46. https://doi.org/10.1097/cej.0000000000000169. CrossRefPubMedPubMedCentral

42.

Gillan C, Abrams D, Harnett N, Wiljer D, Catton P. Fears and misperceptions of radiation therapy: sources and impact on decision-making and anxiety. J Cancer Educ. 2014;29(2):289–95. https://doi.org/10.1007/s13187-013-0598-2. CrossRefPubMed

43.

Bryant AK, Banegas M, Martinez ME, Mell LK, Murphy JD. Trends in radiation therapy among cancer survivors in the United States, 2000-2030. Cancer Epidemiol Biomark Prev. 2017;26:963–70. https://doi.org/10.1158/1055-9965.epi-16-1023. CrossRef

44.

Gudowska I, Ardenfors O, Toma-Dasu I, Dasu A. Radiation burden from secondary doses to patients undergoing radiation therapy with photons and light ions and radiation doses from imaging modalities. Radiat Prot Dosim. 2014;161(1–4):357–62. https://doi.org/10.1093/rpd/nct335. CrossRef

45.

Moye J, Wachen JS, Mulligan EA, Doherty K, Naik AD. Assessing multidimensional worry in cancer survivors. Psychooncology. 2014;23(2):237–40. https://doi.org/10.1002/pon.3381. CrossRefPubMed

46.

Gotay CC, Pagano IS. Assessment of Survivor Concerns (ASC): a newly proposed brief questionnaire. Health Qual Life Outcomes. 2007 Mar 13;5:15. https://doi.org/10.1186/1477-7525-5-15.CrossRefPubMedPubMedCentral

47.

Kroenke K, Spitzer RL, Williams JB, Lowe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50(6):613–21. https://doi.org/10.1176/appi.psy.50.6.613. CrossRefPubMed

48.

Redberg RF, Smith-Bindman R. We are giving ourselves cancer. The New York Times 2014.

49.

Busey JM, Soine LA, Yager JR, Choi E, Shuman WP. Patient knowledge and understanding of radiation from diagnostic imaging. JAMA Intern Med. 2013;173(3):239–41. https://doi.org/10.1001/2013.jamainternmed.1013. CrossRefPubMed

50.

Ludwig RL, Turner LW. Effective patient education in medical imaging: public perceptions of radiation exposure risk. J Allied Health. 2002;31(3):159–64.PubMed

51.

Thornton RH, Dauer LT, Shuk E, Bylund CL, Banerjee SC, Maloney E, et al. Patient perspectives and preferences for communication of medical imaging risks in a cancer care setting. Radiology. 2015;275(2):545–52. https://doi.org/10.1148/radiol.15132905. CrossRefPubMed

52.

Vurnek Zivkovic M, Buljan M, Blajic I, Situm M. Psychological status and illness perceptions in patients with melanoma. Coll Antropol. 2008;32(Suppl 2):75–8.PubMed

53.

American Cancer Society. Can melanoma skin cancer be found early?: American Cancer Society 2016 [cited 2017 March 28, 2017]; Available from: https://www.cancer.org/cancer/melanoma-skin-cancer/detection-diagnosis-staging/detection.html.

54.

Kutner M, Greenberg E, Jin Y, Paulsen C. The health literacy of America’s adults: results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). Washington, DC: U.S. Department of Education: National Center for Education Statistics; 2006; Available from: https://nces.ed.gov/pubs2006/2006483.pdf.

55.

Viswanath K, Breen N, Meissner H, Moser RP, Hesse B, wR S, et al. Cancer knowledge and disparities in the information age. J Health Commun. 2006;11:1–17.CrossRefPubMed

56.

Hay JL, Gold GS, Baser RE, Hricak H, Dauer LT. Prevalence and correlates of worry about the health harms of medical imaging radiation in the general population. J Prim Care Community Health. 2016;7(4):219–25. https://doi.org/10.1177/2150131916648917. CrossRefPubMedPubMedCentral

57.

Shrout PE, Stadler G, Lane SP, McClure MJ, Jackson GL, Clavel FD, et al. Initial elevation bias in subjective reports. Proc Natl Acad Sci U S A. 2018;115(1):E15–e23. https://doi.org/10.1073/pnas.1712277115.CrossRefPubMed

58.

Lam DL, Larson DB, Eisenberg JD, Forman HP, Lee CI. Communicating potential radiation-induced cancer risks from medical imaging directly to patients. AJR Am J Roentgenol. 2015;205(5):962–70. https://doi.org/10.2214/ajr.15.15057.CrossRefPubMed

Title: Prevalence and Correlates of Worry About Medical Imaging Radiation Among United States Cancer Survivors
Authors: Jennifer L. Hay
Raymond E. Baser
Joy S. Westerman
Jennifer S. Ford
Publication date: 01-10-2018
Publisher: Springer US
Published in: International Journal of Behavioral Medicine / Issue 5/2018
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-018-9730-3

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Springer Medicine

Prevalence and Correlates of Worry About Medical Imaging Radiation Among United States Cancer Survivors

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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