Health-related QOL, anxiety and depression in the diagnostic phase of suspected cancer, and the influence of diagnosis | Health and Quality of Life Outcomes | Full Text

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Health-related quality of life, anxiety and depression in the diagnostic phase of suspected cancer, and the influence of diagnosis | Health and Quality of Life Outcomes | Full Text

 Forty-three percent of patients in both diagnosis groups rated their current health as poor or very poor at baseline, and both groups experienced an improvement after receiving knowledge of their diagnosis. There were no significant differences within or between the groups.

Nearly one-third of patients experienced clinical anxiety at baseline irrespective of the final diagnosis. 

Receiving a non-cancer diagnosis can have negative psychological effects and possibly delayed cancer diagnosis in case of subsequent cancer symptoms [1, 47, 48]. Thus, it is essential to acknowledge the possible unintended consequences of a non-cancer result, and provide sufficient information and support to patients receiving a non-cancer diagnosis [48].

Results

A 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.

Conclusions

Patients 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.