Oral Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

  A life course approach to exposure to stressful life events and risk of major depressive symptoms in women after cancer: Results from the Australian Women’s Wellness After Cancer Program (WWACP) (#26)

Charrlotte Seib 1 , Janine Porter-Steele 1 2 , Amanda McGuire 3 , Sarah Balaam 3 , Alexandra McCarthy 3 4 , Debra Anderson 1
  1. Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
  2. Choices Cancer Support Program, Wesley Hospital, Brisbane, Queensland, Australia
  3. Institute of Health and Biomedical Innovation and School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
  4. Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia

There is evidence to suggest that exposure to earlier stressful life events (SLEs) can influence coping strategies and quality of survivorship in women after cancer diagnosis. In this study, we tested alternate life course models to determine which best described associations between exposure to stressors in childhood, adolescence, and adulthood, perceived stress, and self-reported health in women previously treated for breast, gynaecological, and haematological cancer. Data were drawn from 351 Australian women within 2 years of completing active cancer treatment who were participating in the Women’s Wellness After Cancer Program (WWACP) randomised-controlled trial. A model building framework compared the "accumulative risk" and "critical period" stress exposure hypotheses with the saturated model. The best fitting model was then used to explore the correlations between exposure to stressors across the life course, perceived stress (Perceived Stress Scale, PSS), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in women after cancer. Excluding cancer diagnosis and treatment, around half of women aged 18-39 years (48%, n = 169), and 64% during the middle years (n = 228) reported exposure to stressors. Modelling suggested a graded effect between SLEs and health indicators that were consistent with the accumulative hypothesis. Moreover, among women who reported the greatest adversity across the lifespan, they also reported higher perceived stress (PSS, p = 0.02) and had a 2.38 higher odds of major depressive symptoms (95% CI 1.80 - 2.95) compared with those without accumulated SLEs. Findings showed that major depressive symptoms were increased in women with accumulated SLEs and highlights the need for supportive stress-management strategies in women previously treated cancer.