Fear of cancer recurrence, anxiety, and depression among patients with head and neck cancer: a latent change score analysis
Date
2023
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Publisher
University of Delaware
Abstract
Patients with head and neck cancer frequently report some of the highest levels of psychological distress amid managing their disease as well as debilitating and disfiguring treatment side effects. Symptoms of anxiety and depression are common among patients with cancer, but chronic symptoms may lead to impairments in quality of life and emotional health. Fear of cancer recurrence (FCR) is a top unmet need and concern of patients with head and neck cancer. Prior research suggests symptoms of anxiety and depression are potential antecedents to FCR, but findings have been limited to mostly cross-sectional studies in small samples. Utilizing data collected through the Head and Neck 5000 Study in the United Kingdom, the objective of the present study was to examine early level and change in symptoms of anxiety and depression in relation to later change in FCR among patients with head and neck cancer during the first year after diagnosis. A sample of 4891 patients from the parent study completed self-report longitudinal assessments of anxiety, depression, and FCR around the time of diagnosis and 4 and 12 months later. Utilizing a multiple indicator latent change score model, results revealed baseline anxiety level and increases in anxiety from baseline to 4 months were positively associated with change in FCR from 4 to 12 months. Neither baseline depression nor change in depression from baseline to 4 months were significantly associated with later FCR change. Findings suggest that early level and increases in symptoms of anxiety may be a marker of later FCR development. Future research should consider anxiety as a unique antecedent and maintaining factor of FCR and interventions targeting anxiety early in the cancer trajectory may have downstream effects on FCR development.
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Keywords
Anxiety, Depression, Fear of cancer recurrence, Head and neck cancer, FCR development