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Uncertainty and hope in relation to anxiety and depression in advanced lung cancer
  1. Patricia Cruz-Castellanos1,
  2. Mireia Gil-Raga2,
  3. Paula Jiménez-Fonseca3,
  4. Ismael Ghanem1,
  5. Raquel Hernández4,
  6. Nuria Piera-Molons5,
  7. Juana M Cano6,
  8. Alejandro Gallego-Martinez1,
  9. Esmeralda Garcia-Torralba7 and
  10. Caterina Calderon8
  1. 1Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
  2. 2Department of Medical Oncology, Consorci Hospital General Universitari de Valencia, Valencia, Spain
  3. 3Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
  4. 4Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
  5. 5Department of Medical Oncology, Hospital Arnau de Vilanova, Valencia, Spain
  6. 6Department of Medical Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
  7. 7Department of Medical Oncology, Hospital General Universitario Morales Meseguer, Murcia, Spain
  8. 8Department of Clinical Psychology and Psychobiology. Faculty of Psychology, University of Barcelona, Barcelona, Spain
  1. Correspondence to Dr Caterina Calderon, University of Barcelona, Barcelona, 08035, Spain; ccalderon{at}


Objectives Intolerance of uncertainty (IU) has been linked to greater psychological distress, whereas hope appears to act as a protective factor against in patients with cancer. The aim of this study is to analyse the modifying effect of uncertainty in the presence of anxiety and depression in patients with advanced lung cancer.

Methods Multicentre, prospective, observational, cross-sectional study of 145 individuals with advanced lung cancer. Participants completed the following questionnaires: IU Scale, Hert Hope Index, Brief Symptom Inventory.

Results Among patients with advanced lung cancer, anxiety and depression were prevalent, 30% and 35%, respectively. Uncertainty and hope with respect to their illness negatively affected their psychological distress. Hope and uncertainty accounted for 22% of the variance in anxiety and 34% of depressive symptoms. The hypothesised modifying effects (uncertainty×hope) was not supported in the depressive and anxious symptom models.

Conclusions Our findings indicate that hope and uncertainty are important considerations in understanding mental health in people diagnosed with advanced lung cancer. Identifying patients who lack the resources needed to manage uncertainty and hope in relation to their disease could inform psychosocial intervention provision to improve quality of life.

  • Cancer
  • Lung
  • Ethics
  • Psychological care
  • Quality of life
  • Supportive care

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  • Collaborators No aplicable.

  • Contributors PC-C, PJ-F and CC contributed equally to this work: they conducted the database search, screened and extracted the data and wrote the first draft. PJ-F and CC coordinated the project. All Authors made substantial contributions to the conception of the work, data collection, analysis, interpretation of data and approved the final version to be published.

  • Funding This study was funded by the FSEOM (Spanish Society of Medical Oncology Foundation) grant for Projects of the Collaborative Groups in 2018 and by an Astra Zeneca grant (ES2020-1939).

  • Disclaimer The sponsor of this research has not participated in data collection, analysis, or interpretation, in writing the report, or in the decision to submit the article for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.