Scan-associated distress in lung cancer: Quantifying the impact of "scanxiety".
Diagnostic imaging may be a major source of cancer-related distress, a condition known as "scanxiety". Scant scholarly work has been performed to evaluate scan-associated distress in cancer. We sought to characterize risk factors for scan-associated distress among patients with Non-Small Cell Lung Cancer (NSCLC), and to evaluate the impact of scan-associated distress on quality of life.



We conducted a cross-sectional survey study of patients with recurrent/metastatic NSCLC treated at an academic medical center. Clinical and demographic variables were obtained through chart abstraction and patient self-report. We used a modified version of the Impact of Event Scale 6 (IES-6) to specifically assess distress associated with scans, and quality of life was measured using the Functional Assessment of Cancer Therapy - Lung (FACT-L).



Among 103 participants (survey response rate 76.3%), median age was 67, 61.2% were women, and 82.5% were white. At the study visit, 72.8% of subjects discussed a recent scan, and 83% reported some scan-associated distress. Scan-associated distress was not associated with whether the patient had a recent scan, progressive disease or time from diagnosis. Scan-associated distress was associated with impaired quality of life (p=0.004); each unit increase in IES-6 corresponded to an approximately one-unit decrease in FACT-L score.



Scan-associated distress is a common problem among patients with NSCLC, and is associated with impaired quality of life. Scan-associated distress severity was not associated with time since diagnosis or whether a recent scan was discussed at the study visit, which implies scan-associated distress may be a persistent problem.
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States. Electronic address: Joshua.bauml@uphs.upenn.edu.
Joshua M
JM
Bauml
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
Andrea
A
Troxel
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
C Neill
CN
Epperson
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
Roger B
RB
Cohen
Penn State College of Medicine, Hershey, PA, United States.
Kathryn
K
Schmitz
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Carevive Systems, United States.
Carrie
C
Stricker
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
Lawrence N
LN
Shulman
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
Angela
A
Bradbury
Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Jun J
JJ
Mao
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
Corey J
CJ
Langer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000523:psychology*; D003430:Cross-Sectional Studies / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D011877:Radionuclide Imaging / Q000379:methods / Q000523:psychology*; D057566:Self Report; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
Cancer distress; Lung cancer; Quality of life; Scan-associated distress; Scanxiety