Anxiety and depression among long-term survivors of cancer in Australia: results of a population-based survey

Allison W Boyes, Afaf Girgis, Alison C Zucca and Christophe Lecathelinais
Med J Aust 2009; 190 (7): 94.


Objective: To assess the prevalence and predictors of anxiety and depression among a heterogeneous sample of long-term adult cancer survivors.

Design and participants: Cross-sectional survey of 863 adults diagnosed with a new histologically confirmed cancer (local or metastatic) between 1 April and 30 November 1997 and still alive in 2002, living in NSW, able to read and understand English adequately, physically and mentally capable of participating, and aware of their cancer diagnosis, who were randomly selected from the New South Wales Central Cancer Registry.

Main outcome measures: Prevalence of anxiety and depression assessed by the Hospital Anxiety and Depression Scale; and factors (patient, disease, and treatment characteristics; coping style; social support) predicting clinical or borderline levels of anxiety and depression.

Results: Levels of anxiety and depression were low; only 9% of participants reported clinically important levels of anxiety and 4% reported depression. The strongest predictive factors of borderline or clinical anxiety were previous treatment for psychological illness, maladaptive coping styles (helplessness–hopelessness, anxious preoccupation) and poor social support. Borderline or clinical depression was most strongly predicted by previous treatment for psychological illness, being an invalid pensioner, maladaptive coping style (helplessness–hopelessness) and poor positive social interaction.

Conclusions: By 5 years after diagnosis, most survivors had adjusted well to their cancer experience, with levels of anxiety and depression similar to those of the general population. Nevertheless, a small and important group of long-term survivors continue to experience adverse psychological effects and need assistance. Monitoring of psychological wellbeing and referring patients when appropriate need to be integrated into routine care for cancer survivors.

  • Allison W Boyes1
  • Afaf Girgis2
  • Alison C Zucca3
  • Christophe Lecathelinais4

  • Centre for Health Research & Psycho-oncology, Cancer Council New South Wales, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW.


The research on which this report is based was conducted as part of the New South Wales Cancer Survival Study undertaken by the Centre for Health Research & Psycho-oncology (CHeRP). CHeRP is funded by the Cancer Council NSW and the University of Newcastle, with infrastructure funding from the Hunter Medical Research Institute. We thank Elizabeth Tracey (NSW Central Cancer Registry) for case extraction; Dianne O’Connell, Hari Grindley and Heidi Wilcox (Cancer Council New South Wales) for case recruitment; Tara Clinton and Cathy Whiteman (CHeRP) for assistance with data collection; and the cancer survivors who shared their cancer experience.

Competing interests:

None identified.

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