Psychological distress and the leading cancers among American adults : an evidence from the 2013 National Health Interview Survey

Aim: The objective of this study is to determine the prevalence of psychological distress (PD) among cancer patients and to investigate the association of PD with various socio-demographic factors. Methods and results: We consider the 2013 National Health Interview Survey, a large survey of the US non-institutionalized civilian population. PD is determined with a standardized questionnaire (K6). Cancer diagnoses are determined based on self-report. For the purpose of this study, four different types of cancer are selected based on the leading number of deaths caused by them. We fit three commonly used ordinal regression model for PD for both overall cancer patients as well as for patients with four sub-types of (breast, colon, lung, and prostate) cancer. According to the goodness of fit criteria, AIC and deviance, we select the adjacent category model as best model for PD. All the predictors along with afflicted by cancer that were found to be significant in bivariate analysis, are also found to be significant determinants of PD in the multivariate analysis. Subgroup analysis of PD among the subtypes of cancer (breast, colon, lung, and prostate) do not demonstrate any significant determinants of PD. Conclusion: Psychological distress is found to be significantly prevalent among cancer patients that adds extra burden on them. An important finding is that differential psychological distress level exists across different race of overall cancer patients. However, among the different sub types of cancer (breast, colon, lung, and prostate) PD is not found to be different across race.Department of Mathematical SciencesThesis (M.S.