title: Factors associated with cancer worries in individuals participating in annual pancreatic cancer surveillance.
abstract: It is important to adequately and timely identify individuals with cancer worries amongst participants in a pancreatic ductal adenocarcinoma (PDAC) surveillance program, because they could benefit from psychosocial support to decrease distress. Therefore, the aim of this study was to assess both psychosocial and clinical factors associated with cancer worries. High-risk individuals participating in PDAC-surveillance were invited to annually complete a cancer worry scale (CWS) questionnaire which was sent after counseling by the clinical geneticist (T0), after intake for participation in PDAC-surveillance (T1), and then annually after every MRI and endoscopic ultrasonography (EUS) (T2 and further). Analyses were performed to identify factors associated with cancer worries in the second year of surveillance (T3). We found a significant intra-individual decrease in cancer worries (β = -0.84, P < 0.001), nevertheless, 33 % of individuals had a CWS-score ≥14 at T3. We found one factor significantly associated with cancer worries at T3: having a family member affected by PDAC <50 years of age (β = 0.22, P = 0.03). The detection of a cystic lesion, a shortened surveillance interval, or undergoing pancreatic surgery did not lead to more cancer worries (P = 0.163, P = 0.33, and P = 0.53, respectively). In conclusion, this study identified 'a family history of PDAC <50 years of age' as the only predictor of cancer worries experienced after 2 years of surveillance in individuals at high risk of developing PDAC. This knowledge could help clinicians to timely identify individuals 'at risk' for high levels of cancer worries who would likely benefit from psychosocial support.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Ingrid C A W
authors.initials: IC
authors.lastname: Konings
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Femme
authors.initials: F
authors.lastname: Harinck
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, The Netherlands.
authors.forename: Marianne A
authors.initials: MA
authors.lastname: Kuenen
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, The Netherlands.
authors.forename: Grace N
authors.initials: GN
authors.lastname: Sidharta
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, The Netherlands.
authors.forename: Jacobien M
authors.initials: JM
authors.lastname: Kieffer
authors.affiliation: Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Cora M
authors.initials: CM
authors.lastname: Aalfs
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jan-Werner
authors.initials: JW
authors.lastname: Poley
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Ellen M A
authors.initials: EM
authors.lastname: Smets
authors.affiliation: Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Anja
authors.initials: A
authors.lastname: Wagner
authors.affiliation: Family Cancer Clinic, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Anja
authors.initials: A
authors.lastname: van Rens
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frank P
authors.initials: FP
authors.lastname: Vleggaar
authors.affiliation: Department of Clinical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Margreet G E M
authors.initials: MG
authors.lastname: Ausems
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jeanin E
authors.initials: JE
authors.lastname: van Hooft
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Marco J
authors.initials: MJ
authors.lastname: Bruno
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, The Netherlands. e.bleiker@nki.nl.|Family Cancer Clinic, The Netherlands Cancer Institute, Amsterdam, The Netherlands. e.bleiker@nki.nl.
authors.forename: Eveline M A
authors.initials: EM
authors.lastname: Bleiker
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging* / Q000523:psychology* / Q000601:surgery; D019160:Endosonography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology* / Q000601:surgery; D011795:Surveys and Questionnaires
keywords: Cancer worries; High-risk individuals; Pancreatic cancer; Predictive factors; Psychosocial burden; Surveillance