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. 2021 May 26;11(5):e043215. doi: 10.1136/bmjopen-2020-043215

Table 3.

Prevalence and severity of scanxiety

First author Year Measurement of scanxiety Results of scanxiety measurement
Name of tool Range of tool (anxiety threshold*) Timing of assessment Prevalence (%) Severity (mean±SD†) Prescan and postscan comparison
Andolf15 1990 Visual analogue scale 0–100 (NA) Postscan: 1–3 years 81 Median 3.5 (range 0–100) NA
Bull16 1991 HADS: anxiety subscale 0–21 (≥11)‡ Prescan: specific timing NR 4.9 4.97 (range 0–20) Less severe postscan scanxiety, p<0.001
  Postscan: postresult, specific timing NR 4 4.43 (range 0–17)
Peteet17 1992 10-point Likert scale 1–10 (NA) Postscan: specific timing NR NR First scan 5.5, recent scan 3.5 NA
Cockburn18 1994 PCQ: emotional subscale 0–15 (NA) Prescan: day of scan NR <2 No difference
    Postscan: preresults, 1 week postresult and at 8 months NR <2
Ellman19 1995 HADS: anxiety subscale 0–21 (≥11) Prescan: day of scan 6 NR NA
Sutton20 1995 STAI: state anxiety subscale 1–4 (NA) Prescan: at invitation to screening, specific timing NR NR Between 1.65 and 1.95 No significant differences scanxiety at any time point
    Periscan: day of scan NR
    Postscan: 9 months NR
STAI: trait anxiety subscale 1–4 (NA) Prescan: at invitation to screening, specific timing NR NR Between 1.65 and 1.95 No significant differences in scanxiety at any time point
    Periscan: day of scan NR
    Postscan: 9 months NR
GHQ: anxiety subscale 0–3 (NA) Prescan: at invitation to screening, specific timing NR NR <1 Less severe postscan scanxiety, p<0.001
  Postscan: 9 months NR <1
3-point Likert scale 1–3 (NA) Prescan: at invitation to screening, specific timing NR NR <2 Less severe postscan scanxiety, p<0.001
    Postscan: 9 months NR <2
Bakker21 1998 5-point Likert scale Descriptive range (NA) Postscan: immediate and at 3 weeks 39–40 Somewhat, very or extremely: 9%–15% NA
Gupta22 1999 HSCL-25 0–3 (NA) Postscan: specific timing NR 40 Moderate to severe: 25% NA
Hafslund23 2000 STAI: state anxiety subscale 20–80 (NA) Prescan: day of scan NR 35.5±11.0 No statistical comparison reported
  Postscan: day of scan NR 32.1±10.9
STAI: trait anxiety subscale 20–80 (NA) Prescan: day of scan NR 35.9±9.1 No statistical comparison reported
  Postscan: day of scan NR NR
Meystre-Agustoni24 2001 PCQ: negative consequences subscale 0–36 (NA) Prescan: day of scan NR <1 No statistical comparison reported
  Postscan: preresult, 2 weeks postresult and 8 weeks postresult NR <2
6-point Likert scale 0–5 (NA) Prescan: immediate 26 <1
    Postscan: preresult, 2 weeks postresult and 8 weeks postresult NR <1
Drossaert25 2002 Composite seven-item score of 4-point Likert scales 1–4 (NA) Baseline: 8 weeks post-first scan NR 1.6 No statistical comparison reported
  Prescan: 6 weeks (second and third scans) NR 1.6 to 1.7
    Postscan: 6 weeks (second and third scans) NR 1.5
  Descriptive range (NA) Baseline: 8 weeks post-first scan NR Moderate to severe: 10% NA
Sandin26 2002 HSCL-90-R: anxiety subscale 0–4 (NA) Pr-scan: day of scan NR 0.41±0.33 No statistical comparison reported
  Postscan: 2 weeks NR 0.28±0.30
Brunton27 2005 4-point Likert scale, three items Descriptive range (NA) Postscan: within 4 years 56–77 Quite or very: 11%–28% NA
Geurts28 2006 4-point Likert scale 1–4 (NA) Periscan: specific timing NR 61 Moderate to severe: 21% NA
Tyndel29 2007 PCQ: negative consequences subscale 0–36 (NA) Prescan: 1 month NR 5.1±6.7 Less severe postscan scanxiety, p=0.000
  Postscan: 1 month post result and 6 months postresult NR 3.8±6.0 to 4.2±6.2
Cancer Worry Scale – Revised 6–24 (NA) Prescan: 1 month NR 11.0±2.9 Less severe postscan scanxiety, p=0.000
  Postscan: 1 month post result and 6 months postresult NR 10.1±2.5 to 10.6±2.6
Bunge30 2008 IES in low affective risk people 0–75 (NA) Prescan: 1 day NR 5.6±7.9 Less severe postscan scanxiety in both low and high affective risk groups, p<0.05
  Postscan: 6 months NR 4.3±7.2
IES in high affective risk people 0–75 (NA) Prescan: 1 day NR 14.7±14.4
  Postscan: 6 months NR 10.3±11.0
Brown Sofair31 2008 Penn State Worry Questionnaire 16–80 (60) Prescan: within 1 month NR 50.18 (range 40–60) No statistical comparison reported
  Postscan: day of scan (postresult) NR NR
SCL-90-R: anxiety subscale NR (NA) Prescan: within 1 month NR 48.75 No difference
  Postscan: day of scan (postresult) NR 42.07
Individualised Questionnaire: anxiety response 1–3 (2) Prescan: within 1 month 35 NR No statistical comparison reported
  Postscan: day of scan (postresult) 24 NR
van den Bergh32 2008 STAI-6 20–80 (NA) Prescan: 1 day NR 34.1±7.7 Less severe postscan scanxiety, p<0.01
  Postscan: within 1 week and at 6 months NR 32.7±8.4 to 34.3±9.1
IES 0–75 (NA) Prescan: 1 day NR 6.9±9.6 Less severe postscan scanxiety, p<0.01
    Postscan: within 1 week and at 6 months NR 5.1±8.0 to 5.6±8.8
EuroQol questionnaire: anxiety subscale 1–3 (NA) Prescan: 1 day 23 NR No statistical comparison reported
  Postscan: 6 months NR NR
Westerterp33 2008 5-point Likert scale 1–5 (NA) Postscan (after both scans): 2 weeks NR CT 1.2±0.6, PET 1.4±1.0 NA
  Descriptive range (NA) Postscan (after both scans): 2 weeks CT 13, PET 23 Moderate to severe: CT 4%, PET 10% NA
Bastiaannet34 2009 5-point Likert scale 1–5 (NA) Postscan: 2–6 weeks after lymph node dissection Chest x-ray 20, CT 31, PET 36 Moderate to severe: chest X-ray 13%, CT 5%, PET: 9% NA
Vierikko35 2009 Health anxiety inventory 0–24 (NA) Prescan: specific timing NR NR 6.7±4.7 Less severe postscan scanxiety, p<0.001
    Postscan: 1 year NR 5.8±4.6
Worry about lung cancer 0–8 (NA) Prescan: specific timing NR NR 3.0±2.4 No difference
    Postscan: 1 year NR 3.1±2.3
Bölükbaş36 2010 STAI: state anxiety subscale 0-NR (20–39 mild, 40–59 moderate, 60–79 severe,≥80 help needed) Periscan: specific timing NR NR 46.2±4.9 NA
Thompson37 2010 STAI 40–160 (NA) Postscan: specific timing NR 37 65.8±21.0 NA
STAI: state anxiety subscale 20–80 (≥40) Postscan: specific timing NR NR 30.4±10.9 NA
STAI: trait anxiety subscale 20–80 (≥40) Postscan: specific timing NR NR 35.4±11.3 NA
Hutton38 2011 HADS: anxiety subscale 0–14 (≥11) Baseline: 4 weeks pre-first scan 20 6.9±4.2 No difference
  Prescan: day of each scan (for five scans) MRI 17, mammogram 20 MRI 5.2±4.0 to 6.5±4.2,
mammogram 5.0±3.9 to 6.5±4.1
    Postscan: 6 weeks (for five scans) ten to 13 5.1±4.2 to 5.9±4.1
STAI-6 20–80 (NA) Prescan: day of scan (for five scans) NR MRI 10.8±3.8 to 12.1±4.0,
mammogram 10.1±3.9 to 11.3±4.1		 Less severe postscan scanxiety for MRI (p<0.0005) and mammogram (p=0.002)
    Postscan: day of scan (for five scans) NR MRI 9.6±3.2 to 10.7±3.8,
mammogram 9.7±3.1 to 10.5±3.9
IES 0–75 (NA) Postscan: 6 weeks (for five scans) NR MRI 17.8±5.8 to 19.3±7.0,
mammogram 17.2±4.4 to 18.6±5.2		 NA
Pifarré39 2011 STAI 0–60 for each subscale (state more than 10 than trait) Prescan: day of scan 68 NR NA
Steinemann40 2011 7-point Likert scale 1–7 (NA) Prescan: day of scan NR 4.1 NA
Yu41 2011 HADS: anxiety subscale 0–21 (≥8) Prescan: day of scan 38 NR NA
STAI: state anxiety subscale NR-80 (≥40) Prescan: day of scan 46 39.4±12.2 NA
STAI: trait anxiety subscale NR-80 (≥40) Prescan: day of scan 46 39.9±12.2 NA
Dichotomous reporting§ Yes/No (NA) Prescan: day of scan 41 NR NA
Brédart42 2012 STAI: state anxiety subscale 20–80 (≥46) Prescan: 1 week NR MRI 42.1,
mammogram 41.1		 No statistical comparison reported
    Postscan: day of scan and between 15 days to 3 months NR MRI 34.9, 40.8,
mammogram 34.3, 38.8		  
IES: intrusion subscale 0–35 (≥20) Prescan: 1 week NR MRI 8.9,
mammogram 8.4		 No statistical comparison reported
    Postscan: day of scan and between 15 days to 3 months NR MRI 8.5,
mammogram 7.7		  
IES: avoidance subscale 0–40 (≥21) Prescan: 1 week NR MRI 12.1,
mammogram 9.8		 No statistical comparison reported
    Postscan: day of scan nd between 15 days to 3 months NR MRI 11.8,
mammogram 8.9		  
Hafslund43 2012 HADS: anxiety subscale 0–21 (≥8) Prescan: within 2 weeks 15 4.1±3.3 NA
Adams44 2014 4-point Likert scale 1–4 (NA) Postscan: day of scan (after each scan) NR MRI 1.5±0.7, CT 1.8±0.8 NA
Baena-Cañada45 2014 HADS: anxiety subscale 0–21 (≥11) Postscan: specific timing NR 4 1.86±3.26 NA
Cancer Worry Scale 6–24 (NA) Postscan: specific timing NR NR 9.4±3.0 NA
Andersson46 2015 Sum of three items on 5-point Likert scale 0–12 (NA) Postscan: within 4 weeks NR 4 (range 0–10) NA
Elboga47 2015 HADS: anxiety subscale 0–21 (≥10) Prescan: day of scan NR 9.2±3.8 NA
STAI: state anxiety subscale NR (NA) Prescan: day of scan NR 40.4±8.5 NA
STAI: trait anxiety subscale NR (NA) Prescan: day of scan NR 46.6±7.8 NA
Hobbs48 2015 5-point Likert scale 1–5 (NA) Postscan (after both scans), specific timing NR Mammogram 17, MRI 44 NR NA
Bauml49 2016 IES-6 0–24 (NA) Postscan: specific timing NR 83 6.4±5.3 NA
Abreu50 2017 10-point Likert scale 1–10 (NA) Prescan: day of scan NR 6.4±2.7 Less severe postscan scanxiety, p=0.000
    Postscan: day of scan NR 5.7±2.6
Grilo51 2017 STAI: state anxiety subscale 0–60 (NA) Prescan: day of scan NR 31.1±5.2 More severe postscan scanxiety, p=0.000
    Postscan: day of scan NR 33.9±4
Evans52 2018 GHQ-12 0–12 (≥4) Periscans: specific timing NR 42 NR NA
7-point Likert scale 1–7 (NA) Postscan: 1 month NR MRI 2.5±1.3, CT or PET/CT 2.2±1.2 NA
Goense53 2018 5-point Likert scale 1–5 (NA) Postscan (after both scans): day of scan NR MRI 1.0±0.2, PET 1.0±0.2 NA
Hall54 2018 Generalised Anxiety Disorder two-item 0–6 (≥3) Periscan: specific timing NR 26 1.62±1.78 NA
Perceived Stress Scale 4 0–16 (NA) Periscan: specific timing NR NR 5.14±3.35 NA
Derry55 2019 4-point Likert scale Descriptive range (NA) Periscan: preresult NR ‘A great deal’ or ‘completely’: 23% NA
Soriano56 2019 PROMIS Anxiety Short Form 1–5 (NA) Prescan: 2 weeks NR 1.55±0.64 NA
Taghizadeh57 2019 STAI: state anxiety subscale NR (39) Baseline NR 30.9 More severe postscan scanxiety, p<0.001
      Postscan: 1 month postresult and at 12 months NR 33.1, 31.7
Bancroft58 2020 HADS: anxiety subscale 0–21 (11) Baseline Carriers¶: 14
Controls: 7		 Carriers: 6.2±3.9
Controls: 4.9±3.3		 No difference in prevalence
Less severe postscan in carriers (p=0.04)
    Postscan: preresults, at 12 weeks, 26 weeks and 52 weeks Carriers: 5 to 14
Controls: 2 to 7		 Carriers: 5.3±3.9 to 5.9±4.1
Controls: 4.1±3.1 to 4.6±3.3		  
Cancer Worry Scale – Revised 8–32 (NA) Baseline NR Carriers: 14.4±3.6
Controls: 12.2±1.7		 No difference
    Postscan: at 12 weeks, 26 weeks and 52 weeks NR Carriers: 13.6±4.4 to 14.7±4.2
Controls: 11.9±1.4 to 12.1±1.9		  
IES-cancer: intrusion subscale 0–35 (8.5) Postscan: preresults, at 12 weeks, 26 weeks and 52 weeks Carriers: 35 to 58
Controls: 5 to 13		 Carriers: 8.3±9.1 to 11.4±9.1
Controls: 1.7±3.5 to 3.0±4.9		 NA
IES-cancer: avoidance subscale 0–40 (8.5) Postscan: preresults, at 12 weeks, 26 weeks and 52 weeks Carriers: 55 to 64
Controls: 12 to 37		 Carriers: 9.9±9.0 to 13.3±10.5
Controls: 2.6±4.6 to 7.0±8.2		 NA
IES-MRI: intrusion subscale 0–35 (8.5) Postscan: at 12 weeks, 26 weeks and 52 weeks Carriers: 4 to 7
Controls: 0 to 3		 Carriers: 1.2±3.2 to 3.1±8.8
Controls: 0.1±0.3 to 0.5±1.8		 NA
IES-MRI: avoidance subscale 0–40 (8.5) Postscan: at 12 weeks, 26 weeks and 52 weeks Carriers: 14
Controls: 8		 Carriers: 1.8±3.4 to 4.1±9.3
Controls: 0.8±1.4 to 2.8±1.8		 NA
STAI-6 6–24 (NA) Prescan: day of scan NR Carriers: 7.2±3.3
Controls: 7.3±3.2		 NA
Health Questionnaire 0–14 (NA) Baseline NR Carriers: 7.0±2.6
Controls: 6.8±2.2		 No difference
    Postscan: preresults, at 12 weeks, 26 weeks and 52 weeks NR Carriers: 7.1±2.5 to 8.1±2.8
Controls: 6.9±2.2 to 7.7±2.1		  
Grilo59 2020 STAI: state anxiety subscale 20–80 (NA) Prescan: day of scan NR Bone scan: 51.75±3.77
PET/CT: 44.76±10.0		 Less severe postscan scanxiety for both:
bone scan. p=0.02
PET/CT, p<0.001
      Postscan: day of scan NR Bone scan: 36.70±12.12
PET/CT: 38.82±11.33
Morreale60 2020 Distress thermometer 0–10 (4) Periscan: day of scan NR 3.73±2.60 No statistical comparison
    Postscan: 1 week postresult NR 3.91±2.69
HADS: anxiety subscale 0–21 (0–7 none, 8–10 mild, 11–14 moderate, 15–21 high) Periscan: day of scan NR 6.12±3.98 No statistical comparison
  Postscan: 1 week postresult NR 5.32±4.31
Paiella61 2020 Perceived Stress Scale 0–40 (15–18 moderate, ≥19 high) Postscan: preresult NR 14.8 NA

All percentages were rounded to the nearest whole number.

*NA is listed as the anxiety threshold when the study did not state a prespecified threshold. In these cases, the definition of scanxiety prevalence was the percentage of people who reported any degree of anxiety.

†Mean listed unless otherwise described; SD listed only when available.

‡This study did not specify an anxiety threshold; however, the Anxiety subscale of the Hospital Anxiety and Depression Scale has validated thresholds. These thresholds were included in this table

§Dichotomous reporting assumed given description of question (self-perception of anxiety) and results ‘40.5% of the patients considered themselves to be anxious’.41

¶This study included participants who were TP53 mutation carriers and population controls.

GHQ, General Health Questionnaire; HADS, Hospital Anxiety and Depression Scale; HSCL, Hopkins Symptom Checklist; HSCL-90-R, Hopkins Symptom Checklist 90-Revised; IES, Impact of Event Scale; NA, not applicable; NR, not reported; PCQ, Psychological Consequences Questionnaire; PET, positron emission tomography; PROMIS, Patient-Reported Outcomes Measurement Information System; SCL-90-R, Symptom Checklist-90-Revised; STAI, State-Trait Anxiety Inventory.