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Control variables were age, sex, smoking status, cancer type, treatment received, marital status, and education. Results: Stress significantly decreased with time since diagnosis. IES-R scores, which decreased from 16.9 to 11.1, exhibited non-linearity as shown by increases in stress at 6 months, followed by decreases at approximately 12 months (see Figure 1). Interactions between time and cancer treatment were found non-significant, such that the observed trends in stress did not vary due to cancer treatment. For covariates, only education was significantly associated. Patients with a high school education or above had roughly 7-8 points lower mean IES-R scores (less stress) compared to patients with less than high school education. IES-R scores were not significantly associated with survival. Conclusion:This is the first study to describe the course of stress for patients with advanced NSCLC as they received new cancer therapies. It is possible that more frequent assessments of the IES-R would have revealed significant associations with survival. Future research is needed in order to fully understand psychological risk factors for premature mortality from NSCLC.

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