The cancer survival index—A prognostic score integrating psychosocial and biological factors in patients diagnosed with cancer or haematologic malignancies

Gaiger, Alexander; Lubowitzki, Simone; Krammer, Katharina; Acel, Andras; Cenic, Olivera; Schrott, Andrea; Unseld, Matthias; Rassoulian, Anahita; Skrabs, Cathrin; Valent, Peter; Gisslinger, Heinz; Marosi, Christine; Preusser, Matthias; Prager, Gerald W.; Kornek, Gabriela; Pirker, Robert; Steger, G.; Bartsch, Rupert; Raderer, Markus; Simonitsch‐Klupp, Ingrid; Thalhammer, Renate; Zielinski, Christoph; Jäger, Ulrich

doi:10.1002/cam4.4697

Cited by 10 publications

(9 citation statements)

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“…Given the strong impact of psychiatric comorbidities on overall survival in cancer patients (4), there is a need to provide low-threshold, affordable psychosocial care for patients with low income. We also point out, that research efforts examining the impact of the pandemic would be erroneous if other potential influencing factors were not considered.…”

Section: Discussionmentioning

confidence: 99%

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The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

Knefel

Schneckenreiter

Pietschnig

et al. 2022

Preprint

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Background: The COVID-19 pandemic has affected psychological wellbeing in many aspects, but its influence on cancer patients it not yet clear, and studies show mixed results. Aims: We aimed to investigate the impact of the pandemic on psychological symptom burden against the socio-economic background of cancer patients using data from routine assessments before and during the pandemic. Methods: Standardised assessment instruments were applied in N = 1,329 patients to screen for symptoms of anxiety, depression, post-traumatic stress, and fatigue from 2018 to 2022. Two MANOVAs with separate ANOVAs and Bonferroni pairwise comparisons as post-hoc tests were computed. First, only time was included as predictor to examine the isolated impact of the pandemic. Second, income level and education level were included as further predictors to additionally test the predictive power of socioeconomic risk factors. All tests were two-sided. Results: Once indicators of socioeconomic status were included in the analysis, the seeming influence of the pandemic became negligible. Only income had a significant impact on all aspects of psychological symptom burden, with patients with low income being highly burdened (partial eta-squared = .01, p = .023). The highest mean difference was found for depressive symptoms (MD = 0.13, CI = [0.07; 0.19], p < .001). The pandemic had no further influence on psychological distress. Conclusions: Although the pandemic is a major stressor in many respects, poverty is by far the most important risk factor for psychological symptom burden in cancer outpatients and outweighs the impact of the pandemic.

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Section: Discussionmentioning

confidence: 99%

“…The COVID-19 pandemic has a significant impact on mental health in various groups of people all over the world (1,2). People with a cancer diagnosis are at particular risk of developing comorbid mental disorders (3), that not only affect quality of life, but also have a significant impact on physical outcomes and survival (4,5).…”

Section: Introductionmentioning

confidence: 99%

The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

Knefel

Schneckenreiter

Pietschnig

et al. 2022

Preprint

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“…Biological data (cancer site, hemoglobin) was obtained from medical records. We included these data based on previous research 13 and on availability. Anemia was defined as a hemoglobin level ≤14 g/dL for men and ≤12 g/dL for women 14 .…”

Section: Methodsmentioning

confidence: 99%

Risk as a pattern over time: Delineation of time‐dependent risk factors in biological, psychological, and social variables in cancer patients

Knefel

Lubowitzki

Krammer

et al. 2023

Cancer

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BackgroundSurvival in cancer patients is associated with a multitude of biological, social, and psychological factors. Although it is well established that all these factors add to overall mortality, it is not well understood how the predictive power of these parameters changes in a comprehensive model and over time.MethodsPatients who attended the authors’ outpatient clinic were invited to participate. The authors followed 5180 mixed cancer patients (51.1% female; mean age, 59.1 years [SD = 13.8]) for up to 16 years and analyzed biological (age, sex, cancer site, anemia), psychological (anxiety, depression), and social variables (marital status, education, employment status) potentially predicting overall survival in a Cox proportional hazards model.ResultsThe median survival time for the entire sample was 4.3 years (95% confidence interval, 4.0–4.7). The overall survival probabilities for 1 and 10 years were 76.8% and 38.0%, respectively. Following an empirical approach, the authors split the time interval into five periods: acute, subacute, short‐term, medium‐term, and long‐term. A complex pattern of variables predicted overall survival differently in the five periods. Biological parameters were important throughout most of the time, social parameters were either time‐independent predictors or tended to be more important in the longer term. Of the psychological parameters, only depression was a significant predictor and lost its predictive power in the long‐term.ConclusionsThe findings of this study allow the development of comprehensive patient‐specific models of risk and resilience factors addressing biopsychosocial needs of cancer patients, paving the way for a personalized treatment plan that goes beyond biomedical cancer care.

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“…The COVID-19 pandemic had and still has a significant impact on mental health in various groups of people all over the world ( Lafta & Mawlood, 2022 ; Maunder et al., 2021 ; Roy et al., 2021 ). People with a cancer diagnosis are at particular risk of developing comorbid mental disorders ( Zeilinger, Oppenauer et al., 2022 ) that not only affect quality of life, but also have a significant impact on physical outcomes and survival ( Gaiger et al., 2022 ; Knefel et al., 2023 ; Unseld et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

Zeilinger,

Knefel,

Schneckenreiter

et al. 2023

International Journal of Clinical and Health Psychology

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The cancer survival index—A prognostic score integrating psychosocial and biological factors in patients diagnosed with cancer or haematologic malignancies

Cited by 10 publications

References 54 publications

The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

Risk as a pattern over time: Delineation of time‐dependent risk factors in biological, psychological, and social variables in cancer patients

The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

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