Predicting worry following a diagnosis of breast cancer

Measures identified in research as being predictive of later worry following a cancer diagnosis may be too time consuming for routine clinical screening purposes. In practice, therefore, clinicians may use factors such as disease severity to anticipate likely distress. In this study we evaluated alternative predictors based on simple ratings that we had found useful with other patient groups.

Women attending a breast clinic were briefly interviewed on three occasions about their worries: in the clinic immediately before diagnosis and twice after diagnosis, two and four months later. Severity of disease was established using the Nottingham Prognostic Index (NPI).

Severity as assessed by the NPI was not highly correlated with post-diagnostic health worries. The factor found to be most highly correlated with subsequent worry about cancer was patients' ratings of the frequency of thinking about the initial clinic visit during the preceding week.

Given the relative ease of asking about level of pre-diagnostic intrusive thoughts, we conclude that this index would provide a useful and practical method for clinicians to identify in advance those patients likely to worry excessively following a diagnosis of cancer.