Anxiety and quality of life after head and neck cancer in a longitudinal study

Background Anxiety plays a relevant role for tumor patients as a multidimensional psychological factor and influences patients’ quality of life. Anxiety and quality of life (QoL) are often underestimated in tumor follow-up, but are important outcome parameters.

Methods Using "OncoFunction", a patient-reported outcome measure (PROM), 240 patients were surveyed at time points t1-t4 in our tumor follow-up. The evaluated screening questionnaire GAD-2 (scale 0-6) to assess the parameter anxiety, and the items on global QoL from the EORTC- C30 (scale 0-100) were applied.

Results At t1, anxiety was 1.46. QoL at this time point was 52.5. During the course, QoL showed an improvement with 61.1 at t4 (p<0.001). Anxiety, on the other hand, decreased to 1.18 at t3 and significantly increased again to 1.31 at t4. Anxiety appeared to occur at a higher frequency in patients with smaller tumors than in patients with advanced head and neck malignancies (at t4 UICC I 1.52 vs UICC IV 1.23). The values in younger patients were significantly higher than in older patients. Regarding quality of life at t4, patients showed no significant differences in terms of treatment modality or tumor stage, but in terms of employment status as well as ECOG status (p<0.05).

Conclusion Anxiety and quality of life are multidimensional parameters, which are individually different. Anxiety and often resulting decreased QoL increase the risk for complications and have been shown to worsen outcome. Accordingly, it is evident that an individual assessment of these values is immanent in clinical routine in order to identify and treat the need for treatment.

Publication History

Article published online:
12 May 2023