Evaluating the association of self-reported psychological distress and self-rated health on survival times among women with breast cancer in the U.S.

Background: Psychological distress and self-rated health status may create additional complexities in patients already diagnosed with breast cancer. This study aims to assess the association of self-report-based assessment of psychological distress and self-rated health on survival times among women with breast cancer diagnoses.

Methods: Seventeen-year data from the Integrated Public Use Microdata Series-National Health Interview Survey (IPUMS-NHIS) were pooled and analyzed. Women who were aged 30 to 64 years old, with breast cancer diagnosis were selected (n = 2,819). The outcome variable was time to death. The independent variables were self-reported assessment of psychological distress and self-rated health. Psychological distress was defined using the Kessler-6 scale while self-rated health was measured on a 3-point Likert scale: Poor, Fair, and Good-to-Excellent (referred to as good for brevity). We computed unadjusted and adjusted hazard ratios (HR) using Cox-Proportional Hazard regression models with sociodemographic characteristics and measures of health care access used as potential confounders. Significance was set at alpha = 0.05.

Results: Women with breast cancer assessed as having psychological distress had 46% (Adjusted HR: 1.46; 95% CI: 1.02-2.09) increased risks of mortality. Also, women who rated their health as poor or fair had a significantly elevated mortality risk (Poor Health: Adjusted HR: 3.05; 95% CI: 2.61-4.69; Fair Health: Adjusted HR: 1.83; 95% CI: 1.43-2.35) as compared to women with good health status.

Conclusions: Self-reported psychological distress and fair and poor self-rated health are associated with reduced survival times among women with breast cancer diagnoses.