Illness perceptions are associated with mortality among 1552 colorectal cancer survivors: a study from the population-based PROFILES registry

Purpose Cancersurvivorsconstructperceptionsofillnessasa (mal)adaptive mechanism. These perceptions motivate/drive subsequentself-management behaviors toward symptoms and treatment that influence health outcomes.Negativeillnessperceptionshavebeenassociatedwithincreasedmortalityinother chronically ill groups. However, this association is underresearched in cancer survivors. We aimed to explore the association between illness perceptions andmortality instage I–III progression-free colorectal cancer (CRC) survivors.
Methods We used data from the population-based Patient Reported Outcomes Following Initial treatment and Long Term Evaluation of Survivorship (PROFILES) registry of two CRC survivorship studies conducted in 2009 and 2010. We accessed clinical data from the Netherlands Cancer Registry, and mortality data from municipal personal records database. Follow-up was until 31 December 2014. Survivors (n = 1552 ) completed the Brief Illness Perception Questionnaire. Cox proportional hazard models estimated the association between illness perceptions and mortality.
Results Negative illness perceptions on consequences(adjusted hazard ratio (HRadj) 1.60, 95 % confidence interval (CI) 1.14–2.25) and emotion (HRadj 1.65, 95 % CI 1.18–2.31) were associated with higher mortality, after adjusting for demographic, clinical, and lifestyle factors. Smoking and inadequate physical activity were independently associated with mortality for all Brief Illness Perception Questionnaire
Conclusions Survivors’perceptions of their illness are important as these perceptions may influence health outcomes during survivorship period. Clinical practice needs t oidentify and address maladaptive illness perceptions to support more adaptive self-management behaviors and enhance survivorship.
Implications for cancer survivors Cancer survivors may benefit from interventions that address potentially maladaptive perceptions and encourage more adaptive self-management behaviors.