Body Image Concerns and Associated Factors up to Five Years After Cancer in Young Adulthood: A Swedish Longitudinal Population-Based Study.
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OBJECTIVE: This study aims to investigate prevalence of body image disturbance and how perceptions of the body evolve from 1.5 to 5 years following a cancer diagnosis in young adulthood. Additionally, to identify factors associated with worse body image over time. METHODS: A population-based longitudinal study with 1010 individuals diagnosed with breast-, cervical-, ovarian-, testicular cancer, brain tumor or lymphoma at ages 18-39 years was conducted. Participants were approached with surveys 1.5, 3 and 5 years post-diagnosis. Body image was assessed using the Body Image Scale (BIS). Linear mixed models with random intercepts were used to investigate change in body image. RESULTS: Approximately half of females and a fourth of males reported clinical levels of body image disturbance (≥ 10) at 1.5 years post diagnosis, followed by ∼40% and ∼15% respectively at follow-ups. The highest level of body image disturbance was reported among those diagnosed with breast cancer and lymphoma. Body image improved over time among male survivors and females diagnosed with breast cancer and lymphoma (p < 0.001), while other groups remained stable (all p > 0.05). Factors associated with worse body image in both models included intensive treatment and emotional distress. CONCLUSIONS: Although body image was found to improve over time among males and females with breast cancer and lymphoma, a substantial proportion report persistent body image disturbance at follow-up. Future research should employ qualitative methods in exploring the experiences and needs of young adults following cancer, in order to develop timely support for alleviating body image problems.