Supplementary Table 1: Personal and Social Factors

Supplementary Table 1: Personal and Social Factors

All PICT data (n=496)
N / %
Mean age (SD) / 66(11.08)
Age group
Up to age 50 years / 42 / 9
50-59 years / 96 / 19
60-69 years / 161 / 33
70-79 years / 141 / 28
80 years or over / 56 / 11
Sex
Male / 273 / 55
Female / 223 / 45
Centre
Aberdeen Follow-up / 153 / 32
Aberdeen Newly Diagnosed / 141 / 30
Glasgow Newly Diagnosed / 187 / 39
missing / 15
Educationa
Degree from college/university / 57 / 12
Qualification other than degree fromcollege/university / 94 / 20
O-level/Standard Grade/GCSE/Higher/A-level / 126 / 26
None listed/ or other / 203 / 42
Missing / 16
Income
0 to £10,000 / 106 / 27
£10.000 to £20,000 / 123 / 32
£20,001 to £30,000 / 64 / 16
£30,001 to £40,000 / 41 / 10
£40,001 or more / 56 / 14
Missing / 106
Carstairs Quintiles
(least deprived) 1 / 194 / 40
2 / 117 / 24
3 / 60 / 12
4 / 33 / 7
(most deprived) 5 / 87 / 18
Missing / 5
Urban rural status
Remote / 141 / 29
Accessible / 342 / 71
missing / 13
Travelling time
< 1hour / 414 / 84
> 1 hour / 82 / 17
Home Ownership
Own home / 388 / 79
Rent home / 89 / 18
Other / 15 / 3
Missing / 4
Dependents
Yes / 71 / 15
No / 407 / 85
Missing / 18
Living Arrangements
Live alone / 116 / 24
Live with spouse / 321 / 65
Live with family/others / 55 / 11
missing / 4
Employment status
In paid employment/ self-employed / 151 / 30
Retired / 305 / 62
Other / 40 / 8
Smoking status
Never smoker / 188 / 38
Ex smoker / 252 / 51
Current smoker / 54 / 11
Missing / 2

a Where more than one category was ticked the respondent was allocated to the highest qualification category ticked.

Supplementary Table 2: Disease and Treatment Data

All PICT data (n=496)
N / %
Time since diagnosis
up to 26 weeks from diagnosis / 317 / 67
≥48 weeks from diagnosis / 156 / 33
missing / 23
Site of Cancer
Rectal / 157 / 32
Colon / 269 / 55
Rectosigmoid / 59 / 12
Not known / 11
Recurrence
No / 467 / 94
Yes / 29 / 6
Stage at Diagnosis
Complete response to Dukes C / 402 / 81
Metastatic or unstaged / 94 / 19
First Contact
Non-emergency / 416 / 84
Emergency / 80 / 16
Surgery
Elective surgery / 403 / 81
Emergency surgery / 50 / 10
No surgery / 43 / 9
Neo-adjuvant Chemotherapy
None / 400 / 81
Received / 96 / 19
Adjuvant Chemotherapy
None / 324 / 65
Received / 172 / 35
Palliative Chemotherapy
None / 434 / 88
Received / 62 / 12
Neo-adjuvant Radiotherapy
None / 403 / 81
Received / 93 / 19
Adjuvant Radiotherapy
None / 485 / 98
Received / 11 / 2
Palliative Radiotherapy
None / 475 / 96
Received / 21 / 4
STOMA
No / 340 / 69
Yes / 131 / 26
STOMA reversed / 25 / 5

Supplementary Table 3: Patient Reported Co-morbidities

All PICT data (n=496)
N / %
Number of reported co-morbidities
None / 105 / 21
One / 153 / 31
More than one / 238 / 48
Heart disease
No / 410 / 83
Yes / 86 / 17
High blood pressure
No / 308 / 62
Yes / 188 / 38
Diabetes
No / 440 / 89
Yes / 56 / 11
Anxiety/ depression
No / 441 / 89
Yes / 55 / 11
Cancer (other than bowel)
No / 422 / 85
Yes / 74 / 15
Osteoarthritis
No / 419 / 85
Yes / 77 / 15
Current Pain
No / 216 / 45
Yes / 261 / 55
missing / 19

Supplementary Table 4: Case NoteCo-morbidity Data

All PICT data (n=496)
N / %
Mental Health
No / 393 / 79
Yes / 103 / 21
Nervous System
No / 491 / 99
Yes / 5 / 1
Musculoskeletal
No / 396 / 80
Yes / 100 / 20
Cerebrovascular
No / 460 / 73
Yes / 36 / 7
Circulatory System
No / 236 / 48
Yes / 260 / 52
Respiratory
No / 421 / 85
Yes / 75 / 15
Gastrointestinal
No / 447 / 90
Yes / 49 / 10
Endocrine
No / 434 / 88
Yes / 62 / 12
Renal
No / 453 / 91
Yes / 43 / 9
Liver
No / 466 / 94
Yes / 30 / 6
Cancer (other than bowel)
No / 439 / 89
Yes / 57 / 11
Hearing Impairment
No / 455 / 92
Yes / 41 / 8
Visual Impairment
No / 457 / 92
Yes / 39 / 8
Number of recorded co-morbidities
0 / 98 / 20
1 / 132 / 27
2 or more / 266 / 53

Supplementary Table 5 Associations between the HADS anxiety subscale and (1) socio-demographic and lifestyle factors, (2) disease and treatment factors*, (3) co-morbidities (participant reported and casenote recorded), and (4) questionnaire responses to the QLQ-C30, IPQR and SDI.

Odds Ratio / 95%
confidence interval / P-value
Socio-demographic and lifestyle factorsa
(Nagelkerke R2 = 0.097)
Employment Status
Retired / 1.00 / (ref) / 0.018
Employed / 1.60 / (0.95-2.71) / 0.078
Unemployed / 2.80 / (1.29-6.12) / 0.010
Carstairs quintile
(least deprived) 1 / 1.00 / (ref) / 0.047
2 / 1.58 / (0.85-2.90) / 0.146
3 / 0.60 / (0.23-1.56) / 0.298
4 / 2.00 / (0.82-4.90) / 0.129
(most deprived) 5 / 2.07 / (1.08-3.95) / 0.028
Smoking status
Never smoker / 1.00 / (ref)
Ex smoker / 1.48 / (0.86-2.54) / 0.158
Current smoker / 3.14 / (1.50-6.54) / 0.002
Co-morbiditiesb (Nagelkerke R2 = 0.139)
Patient reported anxiety/depression
No / 1.00 / (ref)
Yes / 4.45 / (2.41-8.22) / <0.001
Current Pain
No / 1.00 / (ref)
Yes / 2.60 / (1.54-4.41) / <0.001
QLQ C30c (Nagelkerke R2 = 0.317)
Cognitive functioning / 0.97 / (0.96-0.98) / <0.001
Nausea and vomiting
No / 1.00 / (ref)
Yes / 1.88 / (1.08-3.29) / 0.027
Dyspnoea
No / 1.00 / (ref)
Yes / 2.01 / (1.17-3.47) / 0.012
Sleeping difficulties
No / 1.00 / (ref)
Yes / 2.11 / (1.19-3.74) / 0.011
Diarrohea
No / 1.00 / (ref)
Yes / 1.82 / (1.08-3.09) / 0.025
IPQRd (Nagelkerke R2 = 0.325)
Identity / 1.17 / (1.06-1.29) / 0.02
Illness coherence / 0.93 / (0.87-0.99) / 0.29
Emotional representations / 1.27 / (1.19-1.35) / <0.001
SDIe (Nagelkerke R2 = 0.261)
Domestic chores / 2.63 / (1.45-4.77) / 0.002
Finance / 2.94 / (1.66-5.20) / <0.001
Communication with others / 2.10 / (1.11-3.97) / 0.022
Living arrangements / 3.21 / (1.40-7.34) / 0.006
Isolation / 2.59 / (1.41-4.77) / 0.002
HADSDepression Subscale (Nagelkerke R2 = 0.187)
Non-case / 1.00 / (ref)
Case / 8.12 / (4.80-13.73) / <0.001

*None of the disease and treatment factors were predictive of anxiety caseness using a P-value of 0.1 or less on chi square tests. Factors included in the individual models which were not significant predictors of anxiety were: aHome ownership, living circumstances (alone, with spouse, with others), dependents.bNumber of patient reported co-morbidities, case note recorded mentalhealth or respiratory disease, and number of co-morbidities recorded in the case notes.cPhysical, role and social functioning, and difficulties with fatigue, pain, appetite, constipation, finance.dtimeline, timeline cyclical, consequences, personal control and treatment control.eMaintaining independence, personal care, looking after dependents, support for close others, benefits, financial services, work, planning for the future, communicating with close others, sexual matters, plans to have a family, body image, getting around, living circumstances, recreational activities, travel and holiday plans, other areas of everyday life.

Supplementary Table 6 Associations between the HADS depression subscale and (1) socio-demographic and lifestyle factors, (2) disease and treatment factors, (3) co-morbidities (participant reported and casenote recorded), and (4) questionnaire responses to the QLQ-C30, IPQR and SDI.

Odds Ratio / 95%
confidence interval / P-value
Socio-demographic and lifestyle factorsa
(Nagelkerke R2 = 0.039)
Home Ownership
Own home / 1.00 / (ref) / 0.010
Rent home / 2.51 / (1.34-4.70) / 0.004
Other / 2.60 / (0.65-10.47) / 0.178
Disease and treatment factorsb
(Nagelkerke R2 = 0.057)
Time since diagnosis
up to 26 weeks from diagnosis / 1.00 / (ref)
≥48 weeks from diagnosis / 0.48 / (0.24-0.80) / 0.007
Neo-adjuvant Radiotherapy
None or missing / 1.00 / (ref)
Received / 2.51 / (1.41-4.45) / 0.002
Co-morbiditiesc (Nagelkerke R2 = 0.142)
Patient reported anxiety/depression
No / 1.00 / (ref)
Yes / 2.03 / (1.06-3.90) / 0.033
Current Pain
No / 1.00 / (ref)
Yes / 5.14 / (2.73-9.67) / <0.001
QLQ C30d (Nagelkerke R2 = 0.533)
Physical functioning / 0.98 / (0.96-0.99) / 0.002
Cognitive functioning / 0.97 / (0.95-0.98) / <0.001
Social functioning / 0.97 / (0.95-0.98) / <0.001
Pain
No / 1.00 / (ref)
Yes / 2.28 / (1.06-4.92) / 0.036
Constipation
No / 1.00 / (ref)
Yes / 2.50 / (1.24-5.06) / 0.011
IPQRe (Nagelkerke R2 = 0.296)
Identity / 1.14 / (1.03-1.26) / 0.011
Timeline / 0.91 / (0.85-0.97) / 0.004
Consequences / 1.12 / (1.05-1.21) / 0.001
Treatment control / 0.83 / (0.75-0.92) / 0.001
Emotional representations / 1.21 / (1.13-1.30) / <0.001
SDIf (Nagelkerke R2 = 0.335)
Domestic chores / 2.26 / (1.01-5.04) / 0.047
Personal care / 3.32 / (1.73-6.37) / <0.001
Communication with others / 3.51 / (1.80-6.86) / <0.001
Sexual matters / 2.29 / (1.26-4.15) / 0.006
Isolation / 2.05 / (1.04-4.03) / 0.039
Getting around / 1.80 / (0.94-3.42) / 0.074
HADSAnxiety Subscale (Nagelkerke R2 = 0.187)
Non-case / 1.00 / (ref)
Case / 8.12 / (4.80-13.73) / <0.001

Factors included in the model which were not significant predictors of depression were: aEducation, Income, Home Ownership, Employment status, and smoking status. bSite of cancer, record of recurrent disease, first contact (emergency versus non-emergency) and stoma status.cNumber of patient reported co-morbidities, case note recorded musculoskeletal disease. dRole,functioningand difficulties with fatigue, nausea and vomiting, dyspnoea, sleep, appetite, diarrhoea, finances. etimeline cyclical, personal control and illness coherence.fMaintaining independence, looking after dependents, support for close others, benefits, finance, financial services, work, planning for the future, communicating with close others, plans to have a family, body image, living circumstances, recreational activities, travel and holiday plans, other areas of everyday life.