Anxiety after completion of treatment for early stage breast cancer: a systematic review to identify candidate predictors and evaluate multivariable model development

Harris, Jenny, Cornelius, V, Cheevers, Katy, Ream, Emma and Armes, Jo (2017) Anxiety after completion of treatment for early stage breast cancer: a systematic review to identify candidate predictors and evaluate multivariable model development Supportive Care in Cancer, 25 (7). pp. 2321-2333.

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Abstract

Purpose: To identify potential candidate predictors of anxiety in women with early stage breast cancer (BC) after adjuvant treatments and evaluate methodological development of existing multivariable models to inform the future development of a predictive risk stratification model (PRSM).

Methods: Databases (MEDLINE, Web of Science, CINAHL, CENTRAL and PsycINFO) were searched from inception to November 2015. Eligible studies were prospective, recruited women with stage 0-3 BC, used a validated anxiety outcome ≥ 3 months' post-treatment completion and used multivariable prediction models. Internationally accepted quality standards were used to assess predictive risk of bias and strength of evidence.

Results: Seven studies were identified, five were observational cohorts and two secondary analyses of RCTs. Variability of measurement and selective reporting precluded meta-analysis. Twenty-one candidate predictors were identified in total. Younger age and previous mental health problems were identified as risk factors in ≥ 3 studies. Clinical variables (e.g. treatment, tumour grade) were not identified as predictors in any studies. No studies adhered to all quality standards.

Conclusions: Pre-existing vulnerability to mental health problems and younger age increased the risk of anxiety after completion of treatment for BC survivors, but there was no evidence that chemotherapy was a predictor. Multiple predictors were identified but many lacked reproducibility or were not measured across studies, and inadequate reporting did not allow full evaluation of the multivariable models. The use of quality standards in the development of PRSM within supportive cancer care would improve model quality and performance thereby allowing professionals to better target support for patients.

Item Type:	Article
Subjects :	Health Sciences
Divisions :	Faculty of Health and Medical Sciences > School of Health Sciences
Authors :	Name Email ORCID Harris, Jenny jen.harris@surrey.ac.uk Cornelius, V Cheevers, Katy k.cheevers@surrey.ac.uk Ream, Emma e.ream@surrey.ac.uk Armes, Jo jo.armes@surrey.ac.uk
Date :	12 April 2017
Identification Number :	10.1007/s00520-017-3688-6
Copyright Disclaimer :	The final publication is available at Springer via http://dx.doi.org/10.1007/s00520-017-3688-6
Uncontrolled Keywords :	Breast cancer; Anxiety; Predictors; Risk; Supportive care; Systematic review
Depositing User :	Symplectic Elements
Date Deposited :	29 Mar 2017 08:59
Last Modified :	12 Apr 2018 02:08
URI:	http://epubs.surrey.ac.uk/id/eprint/813875

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