Psychological distress in survivors of head/neck cancer

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DESCRIPTION (provided by applicant): The overall aim of this R21 application is to facilitate the study of head and neck cancer survivorship. This will be accomplished via two specific aims: 1. Identify the most appropriate and cost-effective control group for head and neck cancer survivors. 2. Gather pilot data on psychological distress for a future R01 application to study long-term survivors (5-years and more beyond diagnosis) of head and neck cancer. Part of the challenge of conducting long-term cancer survivorship research is to identify an appropriate control group. This is especially true in head and neck cancer because the disease disproportionately affects older, ethnoracially diverse men who may be from a lower socioeconomic stratum. To achieve our aim we will recruit 100 long-term survivors from the tumor registry to participate in a telephone interview regarding psychological distress, quality of life, and physical function. Two control groups will be utilized. First, as part of the interview, survivors will be asked to identify 2-3 friends of the same sex, age, race, and work status, with no history of cancer, and who would be willing to take part in a similar 30-minute telephone interview. This is the most likely method to yield a control group that is demographically similar to the survivor group. The disadvantage of this approach is that some survivors may be unwilling or unable to identify friends who would participate and some survivors may nominate several friends, potentially biasing the control group. Using random digit dial (RDD) methodology, a second control group (n=100) will be drawn from the survivors' census tracts and frequency matched on sex, age, and race of the cancer survivor group. In the current atmosphere, the yield rate from RDD calls is low. Additionally, older individuals may be suspicious of telephone interviewers, thus it is unclear whether this is the most cost-effective methodology for recruiting an appropriate control group. Between-group comparisons will be conducted to determine which control group yields the best match with the survivor group on sex, age, occupation, socioeconomic status, and race. A final goal of this project will be to collect pilot data for an R01 application. Data will be compared to population-based norms for older men on standardized indices, as well as on illness-specific indices appropriate for this population. Normative data, effect sizes for determination of future sample size requirements, and cost-effectiveness of control group selection methodologies will be established for survivorship research in this understudied population.