(PS6-A25) Mapping Risk and Protective Factors to Trajectories of Cancer-specific Stress in Gynecologic and Breast Cancer Patients: A Latent Growth Mixture Model Analysis

Introduction: Gynecologic and breast cancers represent approximately 43% of cancer diagnoses in women in the United States and report significant rates of cancer-specific stress (CSS) the start of treatment. Therefore, it is important to investigate the long-term associations between CSS and psychosocial functioning in this population and better inform the development of behavioral interventions to decrease CSS.  Aim 1 identified trajectories of CSS over the course of a year, starting at the beginning of chemotherapy. Aim 2 examined psychosocial factors that predicted trajectory class membership.

Methods:  Participants were women diagnosed with stage I-III breast or gynecologic cancer undergoing chemotherapy.  The analysis dataset consisted of 77 participants at baseline, 73 participants at the four month follow up (95% retention), 58 participants at the eight month follow up (75% retention rate) and 58 participants at the one year follow up (75% retention rate). Therefore, there were a total of 266 observations. Growth Mixture Modeling was used to identify distinct trajectories of CSS. Multinomial regression examined potential psychosocial predictors of trajectory membership.

Results: In the 4-class solution, all four trajectories demonstrated a decrease in CSS over the year but with differing intercepts and magnitudes of slopes. These were characterized as the recovery (68.0%), resilience (21.5%), chronic (11.4%), and severly chronic (6.3%) based on their intercept and magnitude of their slope decreasing. The recovery group reported significantly higher insomnia scores (p < .001) than the resilient group. The chronic group reported significantly higher insomnia (p < .001), depression (p < .001), and lower social support (p < .001), and optimism (p < .001) than the resilient group. The chronic group reported significantly lower social support (p < .001) and optimism (p < .05), and higher depression (p < .001) compared to the recovery group.

Conclusions: The findings provide critical information about psychosocial risk factors for CSS in patients with breast and gynecologic cancers and can be used to inform treatment optimization.