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Behavioral Health and Cancer

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Abstract

By 2026, there will be an estimated 20.3 million cancer survivors, the majority of whom will be disease-free and return to primary care providers. Cancer is a disease having modifiable behavioral factors capable of reducing risk, morbidity, and premature cancer death. Survivorship care can improve with integrated healthcare. Behavioral aspects of and interventions for primary, secondary, and tertiary cancer prevention are discussed. For primary prevention, the focus is on modifiable behaviors for reducing exposure to cancer-causing substances, practices, and environments. For secondary prevention, behavioral aspects of usage and adherence to screening for breast, cervix, and colon cancers are discussed. As there is a large tertiary prevention literature, the focus is on the detection and treatment of stress, anxiety, and depressive symptoms to reduce morbidity and mortality. Each section provides the following: (1) prevention definition, (2) characteristics of individuals at risk, (3) barriers to prevention, and (4) guidelines for prevention or treatment. Also provided are discussions of (5) behavioral care, with an emphasis on efforts/interventions used in primary care settings; (6) behavioral interventions of low, moderate, and high intensity; and (7) the efficacy/effectiveness of interventions with individuals at risk. Finally, commentary on the role of behavioral science in oncology is provided, emphasizing training, role and expertise of psychologists, and financial issues in service delivery.

Keywords

  • Cancer
  • Behavioral medicine
  • Biobehavioral
  • Prevention
  • Psychosocial interventions

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Fig. 14.1
Fig. 14.2

Notes

  1. 1.

    While screening is also shown to reduce mortality for lung cancer among long-term and/or heavy smokers (e.g., ≥30 pack-year smoking history), it is not recommended for the general population. For that reason, we have chosen not to review it here.

  2. 2.

    Current U.S. Preventive Services Task Force (USPSTF) recommendations advise against clinicians teaching women how to perform breast self-examination (U.S. Preventive Services Task Force, 2016).

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Conley, C.C., Ryba, M.M., Andersen, B.L. (2018). Behavioral Health and Cancer. In: Duckworth, M., O'Donohue, W. (eds) Behavioral Medicine and Integrated Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93003-9_14

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