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

Ann Oncol. 2010 Nov;21(11):2262-2266. doi: 10.1093/annonc/mdq215. Epub 2010 Apr 27.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety*
  • Cross-Sectional Studies
  • Fear*
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoma / diagnostic imaging*
  • Lymphoma / mortality
  • Lymphoma / psychology*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / psychology*
  • Neoplasm Staging
  • Physician-Patient Relations
  • Prognosis
  • Survival Rate
  • Survivors / psychology*
  • Tomography, X-Ray Computed*
  • Young Adult