Table 2.

The Prevalence, Severity, and Correlates of Anxiety, Depression, Distress and Fear of Cancer Recurrence

Study #	Quality Rating	Citation, Year	Q1: Prevalence Questionnaire [Cut-Point], % (95% CI)*	Q1: Severity Questionnaire [Full Scale Range], Mean (SD, if provided)	Q1: Prevalence (P) and/or Severity (S) Relative to CG (of Non-TC Survivors)	Q2: Demographic, Disease and Treatment Correlates	Q3: Associations Between PROs
Anxiety
1	Good	Bandak et al, 201832	HADS [≥7], 20%	NR	NA	NR	NR
3	Good	Skott et al, 201934	HADS [>7], 21.08%	NR	NA	Non-sig: age	NR
4	Fair	Adams et al, 201830	NR	SSAS-10 [20–80, unclear how they weighted the scores]: baseline exercise group: 18.6 (5.5), baseline control: 16.2 (4.7).	NA	NR	NR
5	Fair	Manhães et al, 201933	HADS [≥8], 6.9%	HADS [0–21], 3.2 (3.8)	NA	NR	Sexual Confidence and Functioning (p = 0.04), Cognitive-Emotional Regulation (p = 0.001), and Specific Sexual Functioning (p = 0.04) were predictors of anxiety symptoms (R2= 61%).
8	Fair	Whitford et al, 201929	NA	HADS [0–21], Baseline Group A: 6.16 (4.08), baseline group B: 4.13 (3.69); FU Group A: 4.72 (3.36), FU Group B: 3.25 (3.69)	NA	Non sig: Treatment type (surgery alone vs surgery + chemo)	NR
Depression
1	Good	Bandak et al, 201832	HADS [≥7], 7%	NR	NA	NR	NR
3	Good	Skott et al, 201934	HADS [>7], 4.7%	NR	NA	Non-sig: age	NR
4	Fair	Adams et al, 201830	NR	CES-D10 [0–30]: baseline exercise group: 5.3 (4.7), baseline control: 4.5 (4.4)	NA	NR	NR
5	Fair	Manhães et al, 201933	HADS [≥9], 6.9%	HADS [0–21], 1.8 (3.7)	No	NA	Sexual Confidence and Functioning was associated with symptoms of depression (p = 0.01). Cognitive-Emotional Regulation (p = 0.001) and Specific Sexual Functioning (P = 0.005) were predictors of symptoms of depression (R2N = 74%).
7	Fair	Wang & Hoyt, 202035	NR	CES-D20 [0–60], 12.99 (12.08)	NA	NR	Depression was significantly and positively correlated with cancer-related masculine threat. Depression was significantly and negatively correlated with benefit finding
8	Fair	Whitford et al, 201929	NR	HADS [0–21], Baseline Group A: 3.05 (3.66), baseline group B: 2.1 (2.21); FU Group A: 2.09 (2.55), FU Group B: 1.8 (2.72)	NA	Non sig: Treatment type (surgery alone vs surgery + chemo)	NR
Distress
2	Good	Kreiberg et al, 202031	PSS [≥16], 25%	PSS [0–40], 11.5 (6.3)	Multivariate adjusted prevalence ratio to reference population 1.56 (95% CI 1.40–1.73, P<0.0001)’.	Age (higher P of stress in TCS until 70 years of age, it changes after this age and the CG becomes the most stressed). Significantly higher S than the general male population in multivariable adjusted analysis for all treatment groups, but no direct comparison between treatment groups. High distress associated with being single, unemployed, and poor self-rated fitness.	NR
4	Fair	Adams et al, 201830	NA	PSS [0–40]: baseline exercise group: 19.7 (8.5), baseline control: 16.3 (9.1).	NA	NR	NR
5	Fair	Manhães et al, 201933	DT [≥4], 41.4%	DT [0–10], 3.2 (2.8)	NA	Cognitive-Emotional Regulation predicted distress (p = 0.01; R2 = 37%).	NR
Fear of Cancer Recurrence
6	Fair	Van Leeuwen et al, 201728	NA	QLQ-TC26 future perspective subscale [0–100], 77 (24)	NR	Marital status: single men had worse FCR (future perspective sub-domain of the QLQ-TC-26)	NR

Note: *or proportions of patients with high levels of the outcome.

Abbreviations: TC, testicular cancer; Q1, research question 1; Q2, research question 2; Q3, research question 3; P, prevalence; S, severity; SD, standard deviation; CG, control group; FU, follow-up; PROs, patient-reported outcomes; FCR, fear of cancer recurrence; HADS, Hospital Anxiety and Depression Scale; PSS, Perceived Stress Scale; CES-D10, Centre for Epidemiologic Studies Depression Scale 10 item scale; CES-D20, Centre for Epidemiologic Studies Depression Scale 20 item scale; SSAS-10, Spielberger State Anxiety Scale 10-item inventory; QLQ-TC26, Quality of Life Questionnaire - Testicular Cancer-26; DT, Distress Thermometer; MOS-HDS, Medical Outcomes Study - Health Distress Scale; Sig, significant; NR, none reported; NA, not applicable.