The faster the better?—A systematic review on distress in the diagnostic phase of suspected cancer, and the influence of rapid diagnostic pathways.
OBJECTIVE
To perform a systematic review of articles published in the last 25 years on prevalence and course of distress and quality of life surrounding the diagnostic process of suspected cancer, and the influence of rapid diagnostic programs.


METHODS
Twenty-three articles were identified via Pubmed, PsycINFO, and reference lists of articles. Except for three randomized clinical trials and one case control study all studies were uncontrolled cohort studies.


RESULTS
Most studies involved patients with suspected breast cancer and therefore had a sex selection bias. Four studies on the effect of rapid outpatient diagnostic programs were found.Studies showed very high prevalence of anxiety, decreasing in case of a benign diagnosis but increasing or sustaining in patients waiting for results or after cancer diagnosis though not significantly more in rapid programs. Quality of life was low and showed varying patterns.


CONCLUSIONS
Distress in the diagnostic phase of cancer is a major problem and the rapid decrease of anxiety in patients eventually not diagnosed with cancer suggests a benefit of rapid diagnostic programs. The available evidence however is limited and shows some inconsistencies. Studies differ in subjects, objective and are limited by quality and quantity. Conflicting results prohibit a conclusion on patients ultimately diagnosed with cancer.
Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. pbrocken@gmail.com
Pepijn
P
Brocken
Judith B
JB
Prins
P N Richard
PN
Dekhuijzen
Henricus F M
HF
van der Heijden
D001007:Anxiety / Q000175:diagnosis / Q000209:etiology*; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors