Anxiety, Depression, and Fear of Cancer Recurrence in Head and Neck Cancer

Objective: Patients with head and neck cancer (HNC) report some of the highest levels of psychological distress amid managing their disease as well as debilitating and disfiguring treatment side effects. Fear of cancer recurrence (FCR) is a top unmet need and concern of patients with HNC. Prior research suggests elevated symptoms of anxiety and depression are potential antecedents to FCR, but findings have been limited in HNC populations. The aim of the present study was to examine the early level and change in symptoms of anxiety and depression in relation to later change in FCR among patients with HNC. Method: The study is a secondary analysis of data collected from 2011 to 2014 through the Head and Neck 5000 Study in the United Kingdom. A sample of 4,891 patients completed self-report longitudinal assessments of anxiety and depression symptoms at baseline, 4, and 12 months and FCR at 4 and 12 months. Results: Utilizing multiple indicator latent change score modeling, results revealed baseline anxiety and increases in anxiety from baseline to 4 months were both positively associated with increases in FCR from 4 to 12 months. Neither baseline depression nor change in depression from baseline to 4 months were significantly associated with FCR change. Conclusions: Findings indicate that early level and increases in symptoms of anxiety were markers of increased FCR in patients with HNC. Future research may consider anxiety as a unique antecedent and maintaining factor of FCR and targeting anxiety early in the cancer trajectory may have downstream effects on FCR development. Objetivo: Los pacientes con cáncer de cabeza y cuello (HNC, por sus siglas en inglés) reportan algunos de los niveles más altos de angustia psicológica durante el manejo de su enfermedad, así como efectos secundarios debilitantes y desfigurantes del tratamiento. El miedo a la recurrencia del cáncer (FCR, por sus siglas en inglés) es una de las principales necesidades y preocupaciones insatisfechas de los pacientes con HNC. Investigaciones anteriores sugieren que los síntomas elevados de ansiedad y depresión son antecedentes potenciales de la FCR, pero los hallazgos han sido limitados en poblaciones con HNC. El objetivo del presente estudio fue examinar el nivel temprano y el cambio en los síntomas de ansiedad y depresión en relación con el cambio posterior en la FCR entre pacientes con HNC. Métodos: El estudio es un análisis secundario de los datos recopilados entre 2011 y 2014 a través d