Addressing Scanxiety Throughout the Cancer Surveillance Journey: A Co-Design Study

Background/Objectives: Scanxiety, the distress associated with cancer surveillance imaging, is a common concern among cancer survivors. Although most research has focused on the imaging event itself, less is known about how scanxiety unfolds throughout the broader cancer surveillance journey. This study aimed to map the cancer surveillance journey of cancer survivors and identify patient-centred intervention opportunities to reduce scanxiety. Methods: We used a qualitative participatory design involving cancer survivors, travelling companions, and healthcare professionals. Nine co-creation workshops were conducted; in six survivors and companions participated in journey-mapping exercises, while in three, healthcare professionals completed an immersive exercise. All groups subsequently engaged in structured brainstorming workshops to generate intervention opportunities. Data were analysed using abductive thematic analysis. Results: Scanxiety extended beyond the imaging procedure and unfolded throughout the cancer surveillance journey, spanning three phases and seven subphases. Participants identified opportunities to redesign the journey by enhancing existing touchpoints, augmenting the journey with additional touchpoints, and eliminating unnecessary or stress-inducing touchpoints. These opportunities targeted interpersonal, technical, environmental, and administrative dimensions of care. Administrative qualities, particularly timeliness and operational processes, emerged as important contributors to distress. Preferences for support and communication varied, underscoring the need for flexible supportive care during medical surveillance. Conclusions: Scanxiety is a journey-wide experience shaped by both individual and organisational factors. Opportunities to address scan-related distress may include not only psychosocial support, but also improvements in how surveillance care is organised and delivered. The findings provide a patient-centred approach for redesigning cancer surveillance services and identifying intervention opportunities for future evaluation.