Development of Psychosocial Distress in Cancer Survivors and Its Potential Prognostic Impact on Survival: A Scoping...

While single-point assessments of psychosocial distress have been associated with survival outcomes, investigations examining longitudinal changes in psychosocial distress and survival outcomes remain limited.

This scoping review evaluates existing literature on longitudinal distress patterns and their association with survival outcomes.

A comprehensive search was performed in PubMed, Web of Science, and PsycInfo databases up to January 2025. Studies were eligible if they included adult cancer survivors, measured psychological distress using validated instruments at minimum two time points, and employed longitudinal cohort designs. Quality assessment used a modified Newcastle-Ottawa Scale. A narrative synthesis was performed due to study heterogeneity.

Of 5028 records screened, 41 studies met criteria, representing diverse geographical regions and cancer types (sample sizes: 74-6054 participants). Eleven examined distress-survival associations; 30 focused on longitudinal changes. Studies identified 2-6 distinct trajectory patterns, with most survivors maintaining low distress levels while a minority experienced chronically elevated symptoms. Persistent or worsening psychological distress was consistently associated with worse survival outcomes across cancer types, while survivors recovering from initial symptoms showed survival rates comparable to those never experiencing distress.

Longitudinal psychological distress patterns may carry prognostic value in cancer survivors, with persistent or worsening symptoms generally associated with worse survival outcomes, though effect sizes varied and findings were not uniformly consistent. These findings suggest a potential role for longitudinal distress monitoring during survivorship care. Whether modifying distress trajectories through psychosocial interventions can improve survival remains unclear and warrants further investigation.