What are the optimal measures to identify anxiety and depression in people diagnosed with head and neck cancer (HNC): a systematic review

Abstract

Background: A cancer diagnosis is potentially life-threatening, likely causing distress and uncertainty, which may be psychologically debilitating. Depression and anxiety are commonly underdiagnosed and undertreated in cancer patients. Head and neck cancer (HNC) patients face particular challenges that may contribute to distress. This review aims to: i) identify patient reported outcome measures (PROMs) designed to assess anxiety and depression in HNC; and ii) determine their suitability for use in research and clinical practice to screen patients. Methods: We searched five electronic databases between July 2007 to July 2019 for studies assessing anxiety and depression in HNC patients. Searches were limited to this period to account for advances in cancer treatment. Records were screened for eligibility by one reviewer and 10% cross-checked by a second across all stages of the review. In addition to the electronic searches, PROM databases were searched for additional measures of anxiety and depression. All retrieved PROMs were mapped against Diagnostic and Statistical Manual-5 criteria for anxiety and depression to assess content coverage. Then, their psychometric properties appraised against the COSMIN checklist. Results: Electronic searches identified 98 records, from which five anxiety and eight depression measures were retrieved. PROM database searches retrieved an additional four anxiety and four depression measures; a total of nine anxiety and 12 depression measures were appraised. Content coverage of anxiety measures ranged from 50% to 75% and depression measures from 42% to 100%. Demonstration of psychometric properties against COSMIN criteria ranged from 57% to 71% for anxiety measures (three PROMs > 70%) and from 29% to 86% for depression measures (nine PROMs > 70%). Three anxiety and seven depression measures had established clinical cutoffs in cancer populations.

Validity of self‐reporting depression in the Tabari cohort study population

“…It should be noted that, even though this inventory was designed for use in clinical populations 10 ; besides, it could also be used in normal populations 9 , 11 .…”

Patient-reported anxiety and depression measures for use in Indian head and neck cancer populations: a psychometric evaluation

“…This study forms part of a larger program of research to translate and evaluate HNC-specific PROMs assessing body image, unmet needs, anxiety and depression into three Indian languages -Tamil, Telugu and Hindi ( [18,19], (Shunmugasundaram, C., et al: Body image scale: Evaluation of the psychometric properties in three Indian head and neck cancer language groups, in preparation), [24,25]).…”

“…PROMs are increasingly used in clinical practice to monitor patient progress and as a communication facilitator between patients and healthcare professionals [17]. Despite the benefits of using PROMs clinically, most PROMs were developed in English, making them non-usable with non-English speaking populations around the world [18,19]. For instance, in countries like India, there are officially 22 different languages with over 700 dialects, and English is only spoken in the big cities, excluding participants from rural areas where nearly 65% of the total population reside [20].…”

“…Our previous work identified the Zung self-rating anxiety scale (SAS) and Patient-health questionnaire 9 (PHQ-9) as HNC-relevant and psychometrically robust PROMs of anxiety and depression [18,[21][22][23]. Both have been culturally adapted into Tamil, Telugu and Hindi and found to be conceptually, linguistically and culturally equivalent to their original English versions [19] following methods proposed by The European Organisation for Research and Treatment of Cancer (EORTC) and Mapi Research Trust (MAPI) guidelines for translation and cultural adaptation of PROMs.…”

Methionine synthase A2756G polymorphism associated with an increased risk of head and neck cancer

“…The most frequent type of HNC is head and neck squamous cell carcinoma (HNSCC) which affects the mucosal lining of head and neck regions. 1 HNC ranked as sixth most common malignancy in the world. 2 In 2019, 65 410 new cases of head and neck cancers reported in the US, which accounted for about 3.7% of new cancers.…”