Scanxiety among Adults with Cancer: A Scoping Review to Guide Research and Interventions

SIMPLE SUMMARY: “Scanxiety”, or the distress and/or anxiety occurring before, during, and after cancer-related imaging/scans, is an upsetting experience during and following cancer. To better understand the nature of scanxiety, related research gaps and practices, and possible ways to help manage it, we conducted a review of the literature using a structured search process. We identified and synthesized findings from 36 articles on scanxiety among adults diagnosed with current or prior cancer. We found that scanxiety occurs across the cancer continuum. The articles also indicated that there are various components of the scan experience that prompt anxiety, such as those related to scan procedures and those related to the implications of important test results. The waiting period between the scan procedure and receipt of the results was described as particularly stressful. Our review also summarizes measures and methods used in scanxiety research. We discuss how the findings of this review may be used to inform future research directions and to generate approaches for helping people to manage scanxiety. ABSTRACT: Background: Scan-related anxiety (“scanxiety”) is distressing to people living with and beyond cancer. We conducted a scoping review to promote conceptual clarity, identify research practices and gaps, and guide intervention strategies for adults with a current or prior cancer diagnosis. Methods: Following a systematic search, we screened 6820 titles and abstracts, evaluated 152 full-text articles, and selected 36 articles. Definitions, study designs, measurement methods, correlates, and consequences of scanxiety were extracted and summarized. Results: The reviewed articles included individuals living with current cancer (n = 17) and those in the post-treatment phase (n = 19), across a breadth of cancer types and disease stages. In five articles, authors explicitly defined scanxiety. Multiple components of scanxiety were described, including those related to scan procedures (e.g., claustrophobia, physical discomfort) and scan results (e.g., implications for disease status and treatment), suggesting varied intervention approaches may be needed. Twenty-two articles used quantitative methods, nine used qualitative methods, and five used mixed methods. In 17 articles, symptom measures specifically referenced cancer scans; 24 included general measures without reference to scans. Scanxiety tended to be higher among those with lower education levels, less time since diagnosis, and greater baseline anxiety levels (three articles each). Although scanxiety often decreased immediately pre- to post-scan (six articles), participants reported the waiting period between scan and results to be particularly stressful (six articles). Consequences of scanxiety included poorer quality of life and somatic symptoms. Scanxiety promoted follow-up care for some patients yet hindered it for others. Conclusions: Scanxiety is multi-faceted, heightened during the pre-scan and scan-to-results waiting periods, and associated with clinically meaningful outcomes. We discuss how these findings can inform future research directions and intervention approaches.