Perception of surgical delay was independently associated with an increased anxiety score after adjusting for age, sex, surgery type, tumor type, history of skin cancer surgery, education, income, and self-reported history of anxiety or depression.
Clinical Pearls
This study aimed to determine whether patient-perceived delays from biopsy to dermatologic surgery for skin cancer were associated with increased patient-reported anxiety during that time
A survey was sent to all patients undergoing skin cancer surgery at a single institution during a three month period which was subsequently completed by 124 patients post-operatively
Perception of surgical delay was independently associated with an increased anxiety score after adjusting for age, sex, surgery type, tumor type, history of skin cancer surgery, education, income, and self-reported history of anxiety or depression
Discussion:
Past studies have described perioperative anxiety being associated with worse-outcomes and decreased patient satisfaction. The authors of this study sought to determine whether patient-perceived delays in treatment of skin cancer were associated with increased patient-reported anxiety regarding their skin cancer surgery in the time between biopsy and surgical treatment.
Each patient treated with Wide Local Excision (WLE) or Mohs Micrographic Surgery (MMS) for skin cancer at a single institution from August to October 2020 was contacted via telephone to participate in this study. Patients were contacted via telephone on post-operative day 0 or 1 to be consented for this study, those who were agreeable to participate were emailed a survey. The Psychosocial Screen for Cancer-Revised (PSSCAN-R) was used to assess anxiety and depression related to skin cancer surgery between biopsy and treatment.
Of the 386 patients who underwent WLE or MMS during this study's time period, 180 were consented and 124 completed the survey. 11 (9%) of patients reported a history of anxiety, 19 (15%) reported a history of depression, and 15 (12%) reported a history of both. Patients who perceived a delay in time to surgery did have a significantly longer time between biopsy and treatment compared with those who did not (p = 0.0001). Perception of surgical delay was also independently associated with an increased PSSCAN-R validated anxiety score after adjusting for age, sex, surgery type, tumor type, history of skin cancer surgery, education, income, and self-reported history of anxiety or depression.
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