Journal of Cancer Survivorship

, Volume 4, Issue 4, pp 291–302

Toward a cancer-specific model of psychological distress: population data from the 2003–2005 National Health Interview Surveys

  • Natalie C. Kaiser
  • Narineh Hartoonian
  • Jason E. Owen



Population-based estimates of emotional distress in cancer survivors are lacking, and little is known about specific correlates of clinically meaningful distress.


Combined 2003–2005 National Health Interview Surveys (NHIS) data were analyzed to evaluate differences in non-somatic distress (measured using the Kessler 6) for those with a history of cancer, those with other chronic health conditions, and healthy adults.


The prevalence of clinically meaningful distress was higher in cancer survivors (5.7%) than those with other health conditions (4.3%) or healthy adults (0.7%). In multivariate models, the strongest correlates of serious distress were younger age, lower educational attainment, lack of health insurance coverage, being unmarried, and having pain, fair/poor health status, or other comorbid conditions. While predictors of distress overlapped considerably between those with cancer and other chronic health conditions, having a history of cancer significantly magnified the effects of age, number of children and elders in the household, and access to health insurance on distress.


The impact of psychological distress is more severe in those with cancer than those living with other chronic health conditions. Those at greatest risk appear to be those with fewer resources to manage their illness.

Implications for cancer survivors

Identifying and understanding correlates of clinically meaningful distress may improve efforts to prevent, identify, and treat significant distress in cancer survivors.


Distress Cancer Survivorship Health disparities 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Natalie C. Kaiser
    • 1
  • Narineh Hartoonian
    • 1
  • Jason E. Owen
    • 1
  1. 1.CB-120, Department of PsychologyLoma Linda UniversityLoma LindaUSA

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