To improve interventions for people with cancer who experience clinically relevant distress, it is important to understand how distress evolves over time and why. This review synthesizes the literature on trajectories of distress in adult patients with cancer. Databases were searched for longitudinal studies using a validated clinical tool to group patients into distress trajectories. Twelve studies were identified reporting trajectories of depression, anxiety, adjustment disorder or post-traumatic stress disorder. Heterogeneity between studies was high, including the timing of baseline assessments and follow-up intervals. Up to 1 in 5 people experienced persistent depression or anxiety. Eight studies examined predictors of trajectories; the most consistent predictor was physical symptoms or functioning. Due to study methodology and heterogeneity, limited conclusions could be drawn about why distress is maintained or emerges for some patients. Future research should use valid clinical measures and assess theoretically driven predictors amendable to interventions.

为了改善对经历临床相关痛苦的癌症患者的干预措施，了解痛苦如何随时间演变以及原因非常重要。本综述综合了有关成年癌症患者痛苦轨迹的文献。使用经过验证的临床工具在数据库中搜索纵向研究，将患者分为痛苦轨迹。十二项研究报告了抑郁、焦虑、适应障碍或创伤后应激障碍的轨迹。研究之间的异质性很高，包括基线评估的时间和随访间隔。多达五分之一的人经历过持续的抑郁或焦虑。八项研究检验了轨迹的预测因素；最一致的预测因素是身体症状或功能。由于研究方法和异质性，关于为什么某些患者会持续或出现痛苦，只能得出有限的结论。未来的研究应使用有效的临床措施并评估可根据干预措施进行修正的理论驱动的预测因素。