Health-related quality of life, anxiety and depression in the diagnostic phase of suspected cancer, and the influence of diagnosis

Abstract

BackgroundUndergoing diagnostic evaluation for cancer has been associated with a high prevalence of anxiety and depression and affected health-related quality of life (HRQoL). The aims of this study were to assess HRQoL, anxiety, and depression pre- and post-diagnosis in patients undergoing diagnostic evaluations for cancer due to non-specific symptoms; to examine changes over time in relation to final diagnosis (cancer yes/no); and to assess the predictive value of pre-diagnostic psychological, socio-demographic and clinical factors.MethodsA prospective, multicenter survey study of patients suspected to have cancer based on non-specific symptoms was performed. Participants completed the EORTC-QLQ-C30 quality of life scale, HADS, SOC-13 and self-rated health before and after completing diagnostic evaluations. Intra- and inter-group differences between patients diagnosed with cancer versus patients with non-cancer diagnoses were calculated. The impact of baseline psychological, socio-demographic, and medical factors on HRQoL, anxiety and depression at follow-up was explored by bootstrapped multivariate linear regression analyses and logistic regression analyses.ResultsA total of 838 patients participated in this study; 679 (81 %) completed the follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of the follow-up. Patients presented initially with a high burden of symptoms and affected role and emotional functioning and global health/QL, irrespective of diagnosis. The prevalence of clinical anxiety prior to knowledge of the diagnosis was 32 % in patients with cancer and 35 % in patients who received a non-cancer diagnosis. HRQoL and anxiety improved after diagnosis, and a larger improvement was seen in patients who received a non-cancer diagnosis. There were no intra- or inter-group differences in the depression scores. The strongest predictors of global QL, anxiety, and depression after a known diagnosis were baseline scores, co-morbidity and poor self-rated health.ConclusionsPatients undergoing diagnostic evaluations for cancer based on non-specific symptoms experience a high prevalence of anxiety and affected quality of life prior to knowledge of the diagnosis. The predictive value of the baseline scores is important when assessing the psychological impact of undergoing diagnostic evaluations for cancer.

Assessment of HER2 status in breast cancer biopsies is not affected by accelerated tissue processing

“…As only one study is known to have assessed the reliability of HER2 assessment with fixation times of less than 6 h, it seems reasonable to dissuade pathology laboratories from using shorter fixation techniques . However, efforts to reduce time to final diagnosis and treatment have become more pressing during recent years, given its impact on stress reduction in patients . This effort not only affects patients who are diagnosed with cancer but, even more so, patients diagnosed with benign disease .…”

The role of oncology nurse navigators in enhancing patient empowerment within the diagnostic phase for adult patients with lung cancer

“…Based on these findings, it can be extrapolated that patient informational and emotional needs were met by the ONNs. Initially, patients might not have recognized community resources as a priority due to high-anxiety levels they experienced during the diagnostic assessment phase (Drageset, 2012;Moseholm et al, 2016). …”

“…Furthermore, the healthcare system is very complex and patients must interact with many healthcare professionals within multiple health services across the cancer care continuum. According to Moseholm et al (2016), undergoing diagnostic evaluation for cancer was associated with a high prevalence of anxiety and depression, which affected health-related quality of life. They reported the prevalence of clinical anxiety prior to knowing about the diagnosis was 32% in patients with cancer and 35% in patients who received a non-cancer diagnosis.…”

Rôles joués par les infirmières pivots en oncologie pour accroître durant la phase diagnostique la responsabilisation des adultes atteints d’un cancer du poumon durant la phase diagnostique

“…Compte tenu de ces constats, on peut estimer que les besoins informationnels et émotionnels des patients ont été comblés par les IPO. À prime abord, les patients n'auraient pas forcément vu les ressources communautaires comme une priorité en raison du degré d'anxiété vécu durant la phase d'éva-luation diagnostique (Drageset, 2012;Moseholm et al, 2016).…”