Journal of Behavioral Medicine

, Volume 36, Issue 6, pp 591–600 | Cite as

Characterizing the psychological distress response before and after a cancer diagnosis

  • Jessica R. SchumacherEmail author
  • Mari Palta
  • Noelle K. LoConte
  • Amy Trentham-Dietz
  • Whitney P. Witt
  • Susan M. Heidrich
  • Maureen A. Smith


Psychological distress among cancer survivors is common. It is unknown if symptoms predate diagnosis or differ from patients without cancer because studies are limited to patient follow-up. Linked cohort (Wisconsin Longitudinal Study) and tumor registry records were used to assess the psychological distress response pre- to post-cancer diagnosis. Adjusted predicted probabilities of being in one of five categories of change for three psychological distress measures (depression, anxiety, well-being) were compared for participants diagnosed with cancer between 1993–1994 and 2004–2005 and participants without cancer (N = 5,162). Cancer survivors were more likely to experience clinically significant increases (≥0.8 standard deviation) in depression (15, 95 % CI = 12–18 %) and anxiety (19 %, CI = 16–22 %) compared to their no-cancer counterparts (10 %, CI = 10–11 %; 11 %, CI = 11–12 %). Cancer survivors <5 years from diagnosis were more likely to experience worsening depression. Survivors ≥5 years were more likely to experience worsening anxiety. No significant results were found for well-being. Characterizing the psychological distress response is a prerequisite for identifying at-risk patients and communicating expected symptoms, allowing for proactive resource provision.


Cancer Oncology Depression Anxiety Quality of life Psychological well-being 



This research was supported by the Agency for Healthcare Research and Quality/National Research Service Award T-32 Institutional Training Program (Grant number T32 HS00083); the National Cancer Institute (Grant number R21 CA137288); the National Institute on Aging (Grant number P01 AG021079); and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research, National Center for Research Resources, National Institutes of Health (Grant number UL1 RR025011). This project was further supported by the Health Innovation Program. This research uses data from the Wisconsin Longitudinal Study of the University of Wisconsin-Madison. Since 1991, the Wisconsin Longitudinal Study has been supported principally by the National Institute on Aging (Grant numbers R01 AG09775, R01 AG033285), with additional support from the Vilas Estate Trust, the National Science Foundation, the Spencer Foundation, and the Graduate School of the University of Wisconsin-Madison. A public use file of data from the Wisconsin Longitudinal Study is available at The opinions expressed herein are those of the authors.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Jessica R. Schumacher
    • 1
    Email author
  • Mari Palta
    • 2
    • 3
  • Noelle K. LoConte
    • 4
  • Amy Trentham-Dietz
    • 2
  • Whitney P. Witt
    • 2
  • Susan M. Heidrich
    • 5
  • Maureen A. Smith
    • 2
    • 6
    • 7
  1. 1.Department of Health Services Research, Management and PolicyUniversity of FloridaGainesvilleUSA
  2. 2.Department of Population Health SciencesUniversity of Wisconsin-MadisonMadisonUSA
  3. 3.Department of Biostatistics and Medical InformaticsUniversity of Wisconsin-MadisonMadisonUSA
  4. 4.Department of Medicine, Section of Hematology/OncologyUniversity of Wisconsin-MadisonMadisonUSA
  5. 5.School of NursingUniversity of Wisconsin-MadisonMadisonUSA
  6. 6.Department of Family MedicineUniversity of Wisconsin-MadisonMadisonUSA
  7. 7.Department of SurgeryUniversity of Wisconsin-MadisonMadisonUSA

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