Scanxiety: Patient experience of immediate result release (IRR) of cancer-related imaging.

Abstract

e13583 Background: The 21 st Century Cures Act, signed in 2016, requires immediate result release (IRR) of labs and imaging results to patients. Patients often receive these results without their providers, raising concerns about “scanxiety” - worry experienced while awaiting or interpreting scan results. A better understanding of scanxiety and patient risk factors can inform targeted interventions to improve patient experience with IRR. Methods: We used a subset of questions from two validated questionnaires, the Impact of Events Scale-Revised and the Fear of Cancer Recurrence – Short Form, to construct a 49-question cross sectional patient survey. We administered the questionnaire to assess cancer-related worry (defined as the cognitive component of anxiety) in patients seen in a multi-site academic Gastrointestinal Oncology clinic in metropolitan New York City between 11/28/23 and 4/25/24. We calculated descriptive statistics for extent of worry. We also analyzed patient demographic and clinical characteristics for associations with worry outcomes. Results: We received 218 responses for an estimated 10% response rate. Responses to most questions were on a 0-4 Likert scale. A total of 105 women (49.5%) and 106 men (50%) responded to the survey, with a median age of 67. Overall, patients reported greater worry regarding possible recurrence or progression of their cancer (composite mean = 2.54, standard deviation = 0.20) as opposed to worry related to their most recent imaging (1.38, 0.27) (p < 0.001). There was a moderately strong positive correlation between baseline worry over cancer progression/recurrence and image-related worry (Pearson’s r = 0.56, 95% confidence interval: 0.46, 0.65). Gender was found to have a significant association with image-related worry frequency (β = 0.46, p = 0.01) and impact of worry on daily functioning (β = 0.58, p < 0.001) with women experiencing greater frequency and impact of worry than men. We found a significant association between age and worry frequency, with each additional decade of age corresponding to a decrease in worry frequency (β = –0.20, p = 0.006). We also found increased patient self-rated confidence in interpreting medical imaging to be inversely associated with worry frequency (β = -0.18, p = 0.02) and impact (β = -0.16, p = 0.02). Notably, cancer stage, marital status, and reason for imaging (surveillance, treatment response, or symptom investigation) were not associated with worry. Conclusions: Overall, we found that patients do worry about cancer-related imaging, albeit less than about disease recurrence and progression. Higher baseline worry about cancer recurrence/progression, female sex, younger age, and lower self-rated confidence in reviewing medical imaging were all positively associated with cancer imaging–related worry. Our research can help to focus interventions on groups at highest risk of scanxiety from early on in their cancer care.