• Lieke van den Brekel, Frederieke H van der Baan, Danielle Zweers, José J Koldenhof, J Bernard H Vos, Alexander de Graeff, Petronella O Witteveen, and TeunissenSaskia C C MSCCMDepartment of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, Cancer Center Un.
• Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands. Electronic address: l.vd.brekel@outlook.com.
• J Pain Symptom Manage. 2020 Sep 1; 60 (3): 522-530.e1.

ContextAnxiety in patients with cancer is highly prevalent; yet it remains underestimated and inadequately assessed. Little is known about predictors for anxiety in hospitalized patients with cancer. Insight in predictors should improve recognition and enable a targeted approach.ObjectivesTo determine the prevalence of anxiety and predictors for anxiety in hospitalized patients with cancer at different stages of disease.MethodsA cross-sectional analysis of patients with cancer admitted to the Utrecht University Medical Center in 2015-2018 was conducted. The Utrecht Symptom Diary, an adapted Dutch version of the Edmonton Symptom Assessment System, was used to assess symptom burden on a numeric rating scale (0 = no symptom and 10 = worst possible symptom). Scores ≥4 were considered clinically relevant. All patients completed the Utrecht Symptom Diary as part of routine care. The first questionnaire after admission was selected. Using multivariable linear regression, the predictive value of potential predictors on anxiety was analyzed.ResultsIn total, 2144 patients were included, of which 22% reported clinically relevant anxiety. The prevalence of anxiety was highest (36%) in patients receiving symptom-directed palliation only. In the total group, female gender, younger age, depressed mood, sleeping problems, dyspnea, and cancer of the head and neck were predictive of anxiety. Throughout all stages of disease, depressed mood was consistently the strongest predictor.ConclusionWe found a high prevalence of anxiety in hospitalized patients with cancer. It is recommended to explore anxiety in hospitalized patients with cancer, in particular when they experience depressed mood. Structural use of a symptom diary during hospitalization facilitates the recognition of anxiety and concurrent symptoms.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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