Aims: To examine factors related to self-reported distress and cancer-related distress among long-term melanoma survivors.
Methods: Participants were ascertained from a population-based cohort of melanoma patients five to nine years post diagnosis. Levels of psychological distress were assessed using the BSI® 18 and cancer-related distress was assessed using the Impact of Events Scale (IES).
Results: A total of 2,516 questionnaires (response rate=74.9%) were received and of those, 2,413 participants completed all items. Using the alternative case rule of a GSI t-score of ≥ 50 for the BSI-18, 30.1% reported clinically significant distress and this was higher in females (33.8%) than males (27.3%) (p<0.001). No significant differences were observed in the proportion reporting significant distress according to thickness of melanoma or years post diagnosis. Clinically significant distress was observed in a higher proportion of participants with recurrent melanoma (45.0%) compared to those with no recurrence (29.2%), p <0.001. In multivariate analysis after excluding participants with recurrent melanoma, factors positively associated with clinically significant distress included female gender (OR=1.28, 95%CI=1.05-1.56); not currently married/living as married (OR=1.54, 95%CI=1.24-1.93); having one or more dependent children (OR=1.26; 95%CI=1.01-1.58); and no private health insurance (OR=1.42, 95%CI=1.16-1.73). Using the IES, cancer-related distress was observed in 15.7% with this being more common in females than males (19.5% and 12.7%, respectively, p <0.001). As age increased the likelihood of cancer-related distress decreased. In multivariate analysis after excluding those with melanoma recurrence, factors positively associated with cancer-related distress included female gender (OR=1.73, 95%CI=1.33-2.24) and age group 20-49 years (OR=2.02, 95%CI=1.12-3.64).
Conclusions: While melanoma is usually a high survival cancer, one in three participants reported clinically significant distress after a minimum of 5 years post diagnosis and over 15% reported cancer-related distress. Findings suggest a need to develop supportive care programs to address the needs of long-term melanoma survivors.