Interconnectivity of fear of progression and generalized anxiety – Network analysis among a sample of hematological cancer survivors

Abstract Purpose: Cancer is associated with fears related to cancer progression (FoP), but may also result in extensive worries related to all areas of daily life implying symptoms of generalized anxiety disorder (GAD). Specific treatment approaches require proper differential-diagnostic, but relevant research is sparse. We applied network analysis to investigate how symptoms of both concepts are interconnected. Methods: We used register-data of a sample of hematological cancer survivors. A regularized Gaussian graphical model including symptoms of FoP (FoP-Q) and GAD (GAD-7) was estimated. We investigated (i) the network structure via partial correlations within and between both constructs and (ii) tested hypotheses on symptoms that may be distinct for each construct by testing if these symtpoms have a low bridge expected influence (BEI). Results: Out of 2001 eligible hematological cancer survivors, 922 (46 %) participated. Mean age was 64 years, 53 % were female. The mean partial correlation within each construct (GAD: r = .13; FoP: r = .07) were greater than between both (r = .01). BEI values among items supposed to discriminate between the constructs (e.g. worry about many things within GAD and fear not to endure treatment within FoP) were among the smallest and thus a-priori hypotheses were largely verified. Conclusions: Our findings based on network analysis support the hypothesis that FoP and GAD are different concepts within oncology. Our exploratory data need to be validated in future longitudinal studies.