Scanxiety: a scoping review about scan-associated anxiety

Abstract

ObjectivesTo identify available literature on prevalence, severity and contributing factors of scan-associated anxiety (‘scanxiety’) and interventions to reduce it.DesignSystematic scoping review.Data sourcesOvid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Scopus, EBSCO CINAHL and PubMed up to July 2020.Study selectionEligible studies recruited people having cancer-related non-invasive scans (including screening) and contained a quantitative assessment of scanxiety.Data extractionDemographics and scanxiety outcomes were recorded, and data were summarised by descriptive statistics.ResultsOf 26 693 citations, 57 studies were included across a range of scan types (mammogram: 26/57, 46%; positron-emission tomography: 14/57, 25%; CT: 14/57, 25%) and designs (observation: 47/57, 82%; intervention: 10/57, 18%). Eighty-one measurement tools were used to quantify prevalence and/or severity of scanxiety, including purpose-designed Likert scales (17/81, 21%); the State Trait Anxiety Inventory (14/81, 17%) and the Hospital Anxiety and Depression Scale (9/81, 11%). Scanxiety prevalence ranged from 0% to 64% (above prespecified thresholds) or from 13% to 83% (‘any’ anxiety, if no threshold). Mean severity scores appeared low in almost all measures that quantitatively measured scanxiety (54/62, 87%), regardless of whether anxiety thresholds were prespecified. Moderate to severe scanxiety occurred in 4%–28% of people in studies using descriptive measures. Nine of 20 studies assessing scanxiety prescan and postscan reported significant postscan reduction in scanxiety. Lower education, smoking, higher levels of pain, higher perceived risk of cancer and diagnostic scans (vs screening scans) consistently correlated with higher scanxiety severity but not age, gender, ethnicity or marital status. Interventions included relaxation, distraction, education and psychological support. Six of 10 interventions showed a reduction in scanxiety.ConclusionsPrevalence and severity of scanxiety varied widely likely due to heterogeneous methods of measurement. A uniform approach to evaluating scanxiety will improve understanding of the phenomenon and help guide interventions.

Smartphone‐based Ecological Momentary Assessment to study “scanxiety” among Adolescent and Young Adult survivors of childhood cancer: A feasibility study

“…The term "scanxiety" was first coined in 2011 to reflect the fear, stress, and anxiety that accompanies scans and awaiting news of their results. 1 Although scanxiety can be considered a normal reaction to a repeated stressor, for many it is a considerably negative experience that impairs quality of life 2,3 and thus warrants research and clinical attention.…”

“…4,5 Most studies of scanxiety have used cross-sectional and retrospective methods to identify risk factors that are timeinvariant (e.g., lower education or a history of smoking) and confer risk for scanxiety over months or years. 3 Instead, EMA allows for dynamic capture of scanxiety across the anticipatory phase (the days or weeks leading up to the scan) and the recovery phase (the days or weeks following the scan) to identify factors that confer risk or protection for scanxiety over shorter periods of time.…”

Effectiveness of educational videos on patient’s preparation for diagnostic procedures: Systematic review and Meta-Analysis

“…However, when experienced in excess, it can hamper the patient’s ability to deal with the stress they are exposed to ( Grilo et al, 2017 ). Anxiety caused by diagnostic procedures is recognized as a standard clinical concern in international cancer institutions ( Bui et al, 2021 , Coping with “Scanxiety” during and after Cancer Treatment, 2021 ).…”

“…Recent qualitative studies ( Bui et al, 2021 ) approached the experience of performing diagnostic procedures, showing that some patients felt fear in the preceding weeks. In some cases, these procedures are perceived by patients as unpleasant and causing claustrophobia ( Bui et al, 2021 , Evans et al, 2017 , Mathers et al, 2011 , Strand et al, 2014 ).…”

Screening for Brain Metastases in Patients With NSCLC: A Qualitative Study on the Psychologic Impact of Being Diagnosed With Asymptomatic Brain Metastases

“…It has been found that follow-up scans (not specifically evaluated for brain imaging) may also have a negative impact on the QoL as these can induce feelings of scan-associated anxiety (scanxiety). 14 , 15 It is not known whether this also accounts for the follow-up with brain imaging.…”