Anxiety symptoms predict head and neck cancer survival: Exploring mediation by systemic inflammation and tumor response to treatment

• DOI: 10.1002/pon.6375
• Publication Date: 2024-07-11T04:49:20Z
• Authors: Hannah Houston; Isak Beck; Christy Albert; Iona Palmer; Baylee Polzin; Alyssa Kabithe; Devaughn Crawford; Jeffrey M. Bumpous; Elizabeth Cash
• Keywords: Male; Inflammation; Adult; Middle Aged; Anxiety; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Head and Neck Neoplasms; Humans; Female; Aged; Proportional Hazards Models

Abstract Background Head and neck cancers (HNC) are associated with high rates of anxiety. Anxiety has been linked to biological pathways implicated in cancer progression, though little is known about its effects on overall survival. We hypothesized that higher pretreatment anxiety levels patients HNC would predict poorer 2‐year survival expected this relationship be mediated by both systemic inflammation tumor response treatment. Methods Patients ( N = 394) reported symptomatology via the GAD‐7 at treatment planning. Pre‐treatment hematology workup provided an index (SII; 292). Clinical data review yielded Logistic multiple regressions Cox proportional hazard models tested relationships. Results Higher were significantly (hazard ratio [HR], 1.039; 95% confidence interval [CI], 1.014–1.066, p 0.002). The association between SII was not significant, (odds [OR], 1.033; CI, 1.001–1.066, 0.043). Tumor fully symptoms (HR, 9.290, 6.152–14.031, < 0.001). Conclusions response, but inflammation, emerged as a potential pathway mediating effect. Screening for may beneficial help prospectively address these concerns ameliorate potentially detrimental impact clinically meaningful outcomes.