Advanced NSCLC: psychosocial factors may play a role in progression, mortality

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  • Higher levels of anxiety after NSCLC diagnosis were associated with a greater risk for lung cancer-specific and all-cause mortality.

Why this matters

  • Psychological distress should be considered when evaluating patients at diagnosis and as part of overall disease management.

Study design

  • Population-based study including 684 patients diagnosed with stage III lung cancer at 2 cancer centers who were routinely assessed for anxiety and depression with the PsychoSocial Screen for Cancer (PSSCAN) questionnaire after diagnosis and before beginning treatment.
  • Funding: None disclosed.

Key results

  • In unadjusted analyses, there were significant associations between anxiety and all-cause mortality (Χ2(1)=4.31; P=.038) and depression and lung cancer-specific (Χ2(1)=8.79; P=.003) and all-cause (Χ2(1)=7.38; P=.007) mortality.
  • After adjustment, there was a significant association between anxiety and lung cancer-specific mortality (HR=1.04; P=.035) and all-cause mortality (HR=1.04; P=.005), but no such association with depression.
  • Depression was significantly associated with both lung cancer-specific (HR=1.03; P=.008) and all-cause (HR=1.04; P=.003) mortality with performance status omitted.


  • Lack of information about smoking habits after lung cancer diagnosis.