The psychological consequences of cancer in Canadian young adults: a national exploration of psychological distress and fear of cancer recurrence

Lane, Breanna Ellen (2021) The psychological consequences of cancer in Canadian young adults: a national exploration of psychological distress and fear of cancer recurrence. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

This project is a cross-sectional exploration of the psychological challenges experienced by young adults (YAs), age 15 to 39, with cancer in Canada and includes two published studies. YAs with cancer across the country completed an extensive online survey, which collected demographic information, cancer history, and included psychometric measures of psychological distress, fear of cancer recurrence (FCR), body image, sleep, well-being, posttraumatic growth and social support. Responses from 508 participants diagnosed with cancer in young adulthood were collected to answer the research questions across the two studies, but the number of participants included in each analysis varies based on completion of outcome measures and matching characteristics. Participant responses from 448 YAs were used to explore whether high psychological distress reported by YAs with cancer is driven by developmental stressors shared by YAs generally, or represents the intersection of cancer and development stressors. An equal number of participants who completed the same distress measure were randomly sampled from the national Canadian Community Health Survey (2012) to create a non-cancer comparison group matched on age, sex and education. YAs with cancer reported significantly greater levels of distress, were less likely to be living independently, and less likely to report annual incomes greater than $40,000. Individual factors associated with experiencing high levels of distress included not working, body image dissatisfaction, poor social support and high FCR. Higher levels of education were a protective factor and associated with decreased likelihood of experiencing high distress. To better understand FCR in YAs with cancer, the responses of 461 participants were utilized to assess prevalence within this population. The prevalence of clinical levels of FCR for YAs with cancer in Canada was 59%, and an additional 25% reported problematic levels. Individuals with a previous recurrence, distress, and body image dissatisfaction were more likely to experience clinical FCR, while those diagnosed with cancer five or more years ago were less likely. The pervasive nature of mental health challenges for YAs with cancer emphasizes how essential psychological support is for this population. Comprehensive, holistic and YA-specific programs are needed to address the developmental needs of YAs with cancer in Canada.

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