Elsevier

Annals of Oncology

Volume 21, Issue 11, November 2010, Pages 2262-2266
Annals of Oncology

original articles
hematologic malignancies
Surveillance CT scans are a source of anxiety and fear of recurrence in long-term lymphoma survivors

https://doi.org/10.1093/annonc/mdq215Get rights and content
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Abstract

Background

We aimed to assess anxiety and the psychological impact of routine surveillance scans in long-term survivors of adult aggressive lymphoma.

Patients and methods

In this cross-sectional observational study of 70 survivors of curable adult aggressive lymphoma, we measured anxiety and the doctor–patient relationship and performed a qualitative interview (n = 30) focused on patient perception of routine follow-up imaging studies.

Results

Participants were diagnosed with aggressive lymphoma a median of 4.9 years (2.4–38.0 years) before enrollment. Thirty-seven percent of patients were found to meet criteria for clinically significant anxiety, which was not associated with years since diagnosis. In multivariate analysis, history of relapse and a worse doctor–patient relationship were independently associated with higher anxiety levels. Despite representing a largely cured population, in qualitative interviews patients reported fear of recurrence as a major concern and considerable anxiety around the time of a follow-up imaging scan.

Conclusions

Routine surveillance scans exacerbate underlying anxiety symptoms and fear of recurrence in survivors of aggressive lymphoma. Strategies to minimize follow-up imaging and to improve doctor–patient communication should be prospectively evaluated to address these clinically significant issues.

Keywords

anxiety
CT scans
lymphoma
survivor

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