UCSF

Purpose and Problem Statement

The purpose of this study, in a sample of women (n=277) and men (n=293) undergoing chemotherapy for either gastrointestinal or lung cancer, was to evaluate for gender differences in coping strategies using the Brief COPE.

Significance

While approximately equal numbers of women and men will be diagnosed with lung and colorectal cancer, women have been underrepresented in both lung and gastrointestinal cancer research. Regardless of cancer site, men have been underrepresented in studies that focus on psychosocial issues associated with a cancer diagnosis and its treatment. This unequal representation of both sexes leaves significant gaps in our knowledge of differences in the way that women and men cope with the diagnosis and treatments associated with lung or GI cancers (i.e., two cancers that have equal occurrence rates in both genders).

Methods

This analysis is part of a larger study that evaluated the symptom experience of outpatients receiving chemotherapy. Patients were recruited from two Comprehensive Cancer Centers, one Veteran’s Affairs hospital, and four community-based oncology programs. Coping data was obtained using the Brief COPE from patients with gastrointestinal (n=412) and lung (n=158) cancer. Gender was identified by self-report.

Results

In terms of the use of engagement coping strategies, women reported higher scores for positive reframing, religion, and using instrumental support. Men reported higher scores for humor. In terms of the use of disengagement coping strategies, women reported higher scores for denial, venting and self-distraction. Men reported higher scores for substance use.

Discussion and implications

This study is the first to evaluate gender differences in coping strategies in a large sample of patients undergoing chemotherapy for gastrointestinal or lung cancer using the Brief COPE. Gender is constructed by a variety of cultural, political, and social norms and has influence on the ways in which people cope, as well as on health outcomes. Gender-based stereotypes of emotional expression may impact how women and men express themselves and the ways in which support is offered to them. Clinicians should be more aware of their own preconceived notions about sex and gender and reflect on how these stereotypes may influence the

psychosocial care they provide to oncology patients. Furthermore, clinicians have the opportunity to assess patients’ use of coping strategies, reinforcing or intervening as appropriate.