BACKGROUND:Patients undergoing cancer-related scans often experience scan-associated anxiety, which can significantly impact their mental well-being. So far, this so-called scanxiety has not been clearly defined, even though it has gained more attention. This study investigated features of scanxiety in cancer patients. METHODS:Two nominal group technique (NGT) sessions were conducted with curatively treated and advanced cancer patients. In the first round, participants took turns sharing features of scanxiety, followed by a group discussion to clarify unclear or overlapping features. Finally, participants rated the extent to which they thought features applied to scanxiety. Additional to the NGT sessions, interviews were conducted with patients and healthcare professionals to provide further insights. Findings from the NGT sessions and interviews were collated and reviewed by the research team using a qualitative content analysis. RESULTS:A total of 16 patients (9 men and 7 women) participated in the NGT sessions and an additional 14 people were interviewed (3 patients and 11 healthcare professionals). The NGT sessions and interviews initially generated 72 and 67 features, respectively. After merging and removing duplicates, the final list of features included 63 features. Following discussions in the multidisciplinary research team informed by predefined decision rules, 23 features were identified as unique to scanxiety. These features reflect emotional, cognitive, behavioural, physiological and physical reactions, social and interpersonal characteristics, and care- and process-related characteristics associated with scanxiety. CONCLUSION:This study provides a first comprehensive characterisation of scanxiety by identifying features that are unique to anxiety associated with cancer-related scans and lays the groundwork for improved assessment and targeted support in cancer care.

Indolent non-Hodgkin lymphoma (iNHL) is a chronic, incurable lymphoid malignancy with a slow course. In absence of symptoms, a ‘watchful waiting’ approach is often chosen. The emotional burden of uncertainty and monitoring may affect patients’ psychological well-being. This study investigates the extent of psychological distress in iNHL patients and its relationship with sociodemographics, clinical characteristics, and quality of life. A cross-sectional study was conducted among adults with histologically confirmed indolent B-cell or T-cell NHL, recruited via a regional Dutch hospital and the online patient platform CMyLife. Data were collected through self-administered online questionnaires, including sociodemographics, clinical characteristics, psychological distress (HADS) and quality of life (EORTC QLQ-C30/LG-NHL). A total of 352 iNHL patients completed the questionnaires (response rate: 37.5

PURPOSE:Theoretical models on fear of cancer recurrence (FCR) have been developed and validated for adult cancer survivors, despite high levels of FCR being found in adolescents and young adults (AYAs). This study intended to empirically validate a model of FCR for AYAs based on the theoretical models of Lee-Jones and Lebel. METHODS:One hundred AYAs diagnosed with cancer between the ages of 15 and 25 were included (59% female). Data were collected online and in-person from four hospitals and one association for young cancer patients in Portugal using the Quality of Life (QoL) Questionnaire Core-30, the FCR7 scale, the Emotion Regulation Questionnaire, the 15-item Systematic Clinical Outcome and Routine Evaluation scale, the Satisfaction with Social Support Scale, and the Hospital Anxiety and Depression Scale. RESULTS:A path analysis showed an excellent model fit: χ2(28) = 30, p = 0.363; Bentler comparative fit index (CFI) = 0.99; Tucker-Lewis index = 0.98; root-mean-square error of approximation = 0.03; standardized root-mean-square residual = 0.08. Significant paths were found from FCR to depressive symptoms and QoL, with friends' support moderating the path between FCR and depressive symptoms. Depressive symptoms and QoL were also related to emotion suppression and friends' support. CONCLUSION:Being satisfied with their friends' support seems to be protective for AYAs with high FCR levels, while satisfaction with family support does not seem to have an influence. This diverges from previous models, supporting the need for a distinct AYA model. Additionally, emotion suppression was related to depression and QoL, but not FCR.

PURPOSE:To study the impact of congenital myopathies in adult patients' lives and their coping mechanisms to live a fulfilling life, in an era with no treatments on the horizon. METHODS:We conducted a qualitative study with semi-structured interviews among Dutch adult patients with congenital myopathies, exploring their experiences of living with the condition. Data from the interviews were analysed through open coding and thematic analysis using Atlas.ti version 24.0.0. RESULTS:Sixteen adult patients (50% females; age range of 26-72 years) were interviewed during January-April 2024. Six main themes were identified: disease management, self-management, personal development, social participation, support, and illness acceptance. Coping strategies were related to aspects of the disease, personal traits of patients and their social environment. CONCLUSION:This study provided a comprehensive perspective going beyond physical functioning, that also considered personal, social, and environmental factors that are crucial for coping with the disease and understanding its impact. These experiences offer valuable insights for clinicians, patients and family members, helping to support patients in finding fulfilment in life.

Background BRCA1/2 pathogenic variant (PV) carriers have an increased risk of tubo-ovarian cancer. They are recommended to have a risk-reducing salpingo-oophorectomy around age 40, resulting in premature menopause. The alternative risk-reducing salpingectomy (RRS) with delayed oophorectomy (DO) postpones this. We present the 5-year results of a nationwide preference trial (TUBA study) comparing menopause-related quality of life (QoL) after RRS/DO with salpingo-oophorectomy.Methods Premenopausal BRCA1/2-PV carriers aged 25-40 (BRCA1) or 25-45 (BRCA2) chose RRS/DO or salpingo-oophorectomy with or without hormonal replacement therapy (HRT). We compared QoL (Greene Climacteric Scale) between RRS/DO and salpingo-oophorectomy without HRT 5 years after surgery using linear mixed models. Secondarily, RRS/DO was compared with salpingo-oophorectomy with HRT. Women who underwent oophorectomy in the RRS/DO group were excluded in a sensitivity analysis.Results In total, 410 (71.9%) participants chose RRS/DO and 160 (28.1%) salpingo-oophorectomy. Seventy-three (17.8%) participants underwent oophorectomy within 5 years after salpingectomy. The adjusted mean difference (aMD) in QoL was 1.8 (95% CI = -0.6 to 4.3) after salpingo-oophorectomy without HRT and 1.4 (95% CI = -0.4 to 3.1) after salpingo-oophorectomy with HRT compared with RRS (with and without oophorectomy) at 5 years follow-up. The sensitivity analysis showed that QoL decreased less after RRS before oophorectomy compared with salpingo-oophorectomy without (aMD = 2.4, 95% CI = 0.1 to 4.8) and with HRT (aMD = 1.9, 95% CI = 0.1 to 3.7).Conclusion Postponing oophorectomy is key in preventing deterioration of QoL. QoL was similar 5 years after salpingectomy (with and without oophorectomy) compared with salpingo-oophorectomy (regardless of HRT use). However, QoL was higher when comparing salpingectomy without oophorectomy to salpingo-oophorectomy (regardless of HRT use).

BACKGROUND:Colorectal cancer (CRC) incidence is rising; consequently, traditional follow-up care models are increasingly unsustainable. Patient-led, home-based follow-up (PHFU) may offer a promising alternative to reduce hospital visits while maintaining patient well-being. METHODS:The DISTANCE trial was a stepped-wedge cluster randomised trial conducted in six hospitals in the Netherlands. A total of 354 stage I-III CRC survivors, disease-free at 12 months after surgery, were assigned to either PHFU or standard follow-up. The primary endpoint was the number of hospital contacts. Secondary endpoints included quality of life (assessed using the European Organisation for Research and Treatment of Cancer core quality-of-life questionnaire (EORTC QLQ-C30); version 3.0), cancer-related worry (assessed using the Cancer Worry Scale (CWS)), and psychological distress (assessed using the Hospital Anxiety and Depression Scale (HADS)). RESULTS:In the intention-to-treat (ITT) analysis, no significant difference in hospital contacts was observed. In the as-treated (AT) analysis, PHFU reduced hospital contacts by 38% compared with standard follow-up (rate ratio 0.62 (95% c.i. 0.51 to 0.75), P < 0.001). There was substantial crossover, with 117 patients assigned to PHFU receiving standard follow-up and 10 patients assigned to standard follow-up receiving PHFU. No significant differences between the two groups were found with regard to quality of life or psychological well-being. CONCLUSION:The DISTANCE trial suggests that PHFU is a feasible and effective alternative to standard hospital-based follow-up for CRC survivors.

BACKGROUND AND OBJECTIVE:In metastatic hormone-sensitive prostate cancer (mHSPC), health-related quality of life (HRQoL) is key for personalised treatment decisions. We compared the impact of different mHSPC treatment strategies on HRQoL, tackling a previously unaddressed challenge in comparing the outcomes across different patient-reported outcome measures (PROMs). METHODS:A systematic review was conducted of prospective studies reporting HRQoL outcomes of androgen deprivation therapy (ADT) alone or with placebo, radiotherapy, abiraterone, apalutamide, enzalutamide, and/or docetaxel in mHSPC (CRD42021227902). Databases were searched in April 2022 and April 2024. HRQoL domains across different PROMs were harmonised using the Wilson and Cleary model. A frequentist network meta-analysis (NMA) compared 12-mo treatment effects using standardised mean differences (SMDs) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. KEY FINDINGS AND LIMITATIONS:Of the 24 articles included, nine were analysed in the NMA (eight trials, n = 6248). ADT + abiraterone resulted in significantly less pain than ADT + placebo (SMD: -0.22, 95% CI [-0.33; -0.10], p < 0.001), ADT + apalutamide (SMD: -0.17, 95% CI [-0.31; -0.02], p = 0.022), and ADT + enzalutamide (SMD: -0.23, 95% CI [-0.37; -0.09], p = 0.001). Less fatigue was observed with ADT + abiraterone versus ADT + enzalutamide (SMD: -0.45, 95% CI [-0.88; -0.02], p = 0.041). ADT + abiraterone showed significantly better physical functioning than ADT + enzalutamide (p = 0.015) and ADT + placebo (p = 0.032). Both were also associated with significantly worse general health perception than ADT alone, ADT + docetaxel, and ADT + radiotherapy. General health perception and overall quality of life were significantly better with ADT + abiraterone than with ADT + enzalutamide, ADT + apalutamide, and ADT + placebo (p < 0.001). The limitations include heterogeneity (0-76%) and few eligible trials. CONCLUSIONS AND CLINICAL IMPLICATIONS:HRQoL outcomes differ across treatment strategies for mHSPC. At 12 mo, ADT + abiraterone yielded the most favourable HRQoL profile.

This study aimed to investigate whether socio-demographic, clinical, and intervention-related variables moderate the effects of exercise on depression and anxiety symptoms in cancer survivors. Data from 26 RCTs in the POLARIS database were analyzed using a one-step individual participant data (IPD) meta-analytic approach with linear mixed models to assess exercise effects on depression and anxiety symptoms (z-scores). Interaction terms were added to these models to explore moderators. Results are presented as betas (corresponding to Cohen’s d effect size). Albeit statistically significant, exercise demonstrated negligible effects on symptoms of depression (β = − 0.11; 95

The field of psychosocial oncology faces many challenges, including the increasing number of cancer survivors in need of psychosocial support, alarming health disparities, and growing health care shortages. In 2024, Dutch psychosocial oncology researchers established the Psychosocial Oncology research COnsortium Netherlands (POCON) to better address these challenges together. In this letter, we describe the strategies we used to successfully launch POCON. After writing a mission statement, we developed a collective psychosocial oncology research agenda by (1) distributing a survey among Dutch senior researchers to determine priority themes for collaboration, (2) visualizing the current Dutch landscape of psychosocial oncology research by modeling a network of keywords based on recent publications in the field, and (3) comparing the identified priority themes and keyword network with more general cancer agendas in the Netherlands. Three overarching themes that were featured throughout these general agendas aligned with the identified priority themes but are currently underrepresented in psychosocial oncology research, as shown by the keyword network: “equity in cancer,” “implementation of innovations,” and “personalized care.” Based on these themes, we established three POCON committees. In addition, we established a fourth committee “Data Inventory” to further facilitate collaboration. Each committee is tasked with developing action plans to strengthen collaborative research efforts. Strategies that proved helpful throughout this process included prioritizing collaboration over competition, keeping up the momentum, and adopting a hands-on approach. By joining efforts and strengthening both national and international research collaborations, we strive to optimize psychosocial care for patients with cancer and their families.

Background:An emerging group of patients with advanced cancer receiving systemic treatment lives long term with ongoing uncertainty, but no valid measure of uncertainty was available for this group. Our aims were to translate the Mishel Uncertainty in Illness Scale-Community (MUIS-C) into the Dutch language and evaluate its psychometric properties in patients with advanced cancer receiving systemic treatment.Methods:Patients (N = 111) with diverse advanced cancer diagnoses and treatments (53% male, mean age 66 years) completed the MUIS-C, which was translated into the Dutch language using a forward-backward translation procedure. Floor and ceiling effects, structural validity, internal consistency, and construct validity were evaluated.Results:No floor and ceiling effects for the MUIS-C were found. Exploratory factor analysis revealed two factors (lack of clarity, unpredictability). Internal consistency was adequate (Cronbach's alpha = 0.82). All a priori hypotheses regarding convergent and divergent validity were confirmed and supported construct validity.Conclusions:Results suggest that the Dutch MUIS-C is a valid and reliable measure for assessing illness uncertainty in patients with advanced cancer and support its use in future studies among patients with advanced cancer receiving systemic treatment.

OBJECTIVE:While nearly 60% of cancer survivors report a heightened fear of cancer recurrence (FCR), not all of them experience functional impairment and want professional psychological care. We applied the network approach to study how different components of FCR (symptoms, triggers, perceived risk, and coping strategies) are interconnected to both FCR severity and functional impairment to better understand which survivors are likely to require psychological care. METHOD:We applied network analysis to cross-sectional data from 3,370 cancer survivors from nine different countries, spanning Asia, Australia, Europe, and North America, from the international Fear of Cancer Recurrence Inventory database. The shortest path analysis was applied to study what components were directly connected to both FCR severity and functional impairment. RESULTS:FCR severity was mainly connected to symptoms and triggers while functional impairment was mainly connected to coping strategies. The shortest paths indicated that worry and bodily triggers were directly connected to both higher FCR severity and more functional impairment. CONCLUSION:Worry and bodily triggers appear to be core components of FCR that are experienced as impairing in daily life. Our findings suggest that assessing functional impairment, worry, and bodily triggers, in addition to FCR severity, could be valuable when screening for clinical levels of FCR. To further improve our conceptual understanding of FCR, future studies should apply intensive longitudinal designs to explore how these components interact over time and within the individual. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective:Cancer comes with considerable psychological and emotional distress, which can persist long after initial treatment. Yet, few digital interventions targeting emotional distress are available for patients with cancer and survivors. Cognitive bias modification (CBM) is a digital intervention designed to reduce emotional distress by repeatedly training automatic processing of positive and disease-specific information. We examined the feasibility, safety, and clinical potential of CBM as secondary prevention of psychiatric disorders.Methods:Three independent pilot studies were conducted in samples with emotional distress: (i) patients newly diagnosed with hematological cancer at the start of their treatment, (ii) patients with cancer receiving chemotherapy, and (iii) cancer survivors >= 5 years after curative treatment receiving long-term survivorship care. Within each study, patients were randomized to either receive four sessions of computer-based active or control CBM or a nonintervention condition. Self-report measures of emotional distress were administered before, directly after, and one week after the intervention. Intervention feasibility and safety were assessed, as well as the direction of symptom change.Results:The intervention was deemed unfeasible in patients newly diagnosed with cancer and patients receiving chemotherapy. In cancer survivors, however, the intervention was well tolerated and possibly clinically relevant. The intervention was considered safe for all three populations.Conclusions:CBM can be considered as a possible secondary prevention digital intervention for cancer survivors. The intervention seems inappropriate for patients with cancer receiving treatment, possibly because the treatment phase itself is too impactful. Future research could examine the preventative potential of CBM in a clinical trial in cancer survivors.

Objective: Few evidence-based interventions addressing high levels of fear of cancer recurrence (FCR) have been implemented. Understanding how these might be implemented is crucial to bridge the research-practice gap. This study investigated the feasibility of implementing the blended Survivors' Worries of Recurrent Disease (SWORD) intervention in real-world psycho-oncology practice. Methods: SWORD was offered for 15 months (2021-2022) as the standard care for clinical FCR in a university hospital, a general hospital, and psycho-oncological center. We evaluated using a mixed-methods design six feasibility outcomes based on Bowen's framework: demand, limited effectiveness, degree of execution, acceptability, practicality, and integration. Anonymous data were collected for all oncology patients on referral. Study participants completed questionnaires before and after treatment, including the Cancer Worry Scale (CWS-6) as the primary measure of effectiveness. Qualitative data included interviews with patients and psychologists, and field notes. Results: Regarding demand, 81 of 644 patients referred (13%) were eligible for SWORD. The uptake of SWORD was 79% (n = 63/80) and the completion rate 73% (n = 46/63). SWORD was effective in reducing FCR (p < 0.001, eta p(2) = 0.694). Regarding execution, a variability in the length, planning and number of treatment sessions was found between different settings. Adherence to the treatment manual's content was high (89%). Regarding acceptability, most patients were satisfied with SWORD (average 8.2/10) and psychologists valued the blended format. Psychologists reported SWORD was practical to deliver given their knowledge and skills. Although differences between settings were found, SWORD integrated well into practice. Referral for FCR and a reluctance to contract new eHealth providers were barriers for implementation. Conclusions: Despite differences between healthcare settings, the implementation of SWORD was evaluated well. The feasibility of SWORD in different settings should inform a national implementation strategy.

PurposeAn emerging group of patients lives longer with advanced cancer while receiving systemic treatment. This study aimed to investigate psychosocial aspects of living longer with advanced cancer, and experiences with psychosocial care, from the perspectives of patients, partners, and health care professionals (HCPs).MethodsFrom May to December 2020, participants were purposively selected. In-depth, semi-structured interviews were conducted by video or phone call, containing open questions regarding psychosocial aspects and psychosocial care in oncology. The data was analysed following thematic analysis, leading to overarching psychosocial themes and indications for optimal organisation of psycho-oncological care.ResultsFifteen patients, seven partners and eleven HCPs were interviewed. The main psychosocial aspects were increasing loss in several life domains, complexity of making life choices, ongoing uncertainty, and fluctuating fear and hope. Partners were affected by their loved ones' condition and reported to put themselves second for longer periods of time, while sometimes missing adequate support. HCPs were challenged by addressing the altering psychosocial needs of patients, and tools to identify those in need for psychosocial support are currently lacking.ConclusionsLiving longer with advanced cancer presents unique challenges for patients and their partners, as well as for HCPs in delivering optimal psychosocial care.Implications for Cancer SurvivorsIdentifying and addressing patients' psychosocial needs from an early stage on, appointing a central hospital-based contact person, limiting the waiting time between scans and consultations, and addressing the partners' wellbeing are suggestions to organise optimal psychosocial support in advanced cancer.

Limited data exists on the long-term course of fear of cancer recurrence (FCR) in head and neck cancer (HNC) patients. One in five patients was found to experience persistent high FCR in the first months after diagnosis. This study assessed the 3-year trajectories and associated factors of FCR in newly diagnosed HNC patients. Six hundred twenty-one patients from the NETherlands Quality of life and Biomedical Cohort study (NET-QUBIC) completed the FCR assessment at baseline, 3-, 6-, 12-, 24-, and 36-months posttreatment. Trajectories of FCR were identified using latent class growth analysis. Multinominal logistic regression analysis was used to assess associations between FCR trajectories and baseline demographic and medical variables, personality, and coping. Three FCR trajectories were identified: “consistently high” (n = 45, 7

Background: The aim of this study was to evaluate the adherence, interrater agreement, and content of a guideline-based semistructured interview for adjustment disorder (AD) in patients with cancer. Methods: In total, 120 AD interviews with patients with cancer were performed by 9 trained psychologists. The interview contained topics related to stressors, resilience, and symptoms and complaints. Audiotaped interviews of 72 patients were available. Adherence to the interview manual was scored by two researchers independently, and the average adherence was calculated per topic. Interrater agreement was calculated using Cohen's Kappa. The content of the interviews was evaluated using thematic analysis of the transcribed interviews of patients with an AD diagnosis. Results: In the interviews, 97% of the topics were covered at least briefly and 78% of all topics were addressed at least adequately. Interviewers asked questions regarding stressors and symptoms and complaints more thoroughly compared with resilience. The interrater agreement regarding the AD diagnosis was moderate (Kappa 0.55). The content analysis showed that stressors and resilience can be additionally specified into physical, psychological, spiritual, and social themes, which are relevant to explore in the context of an AD diagnosis after cancer. Conclusion: The guideline-based interview for AD identifies problems and protective factors with adequate adherence and moderate agreement. A balanced investigation of stressors, resilience, and symptoms is important for optimal clinical decision-making regarding AD in the context of cancer.

Background: The growing group of people with advanced cancer and systemic treatment faces psychosocial challenges, including fear of progression (FoP). This study aimed to identify features that characterize FoP in people with advanced cancer and systemic treatment. Methods: An exhaustive list of possible FoP characteristics was generated based on literature, patient-reported outcome measures on FCR and FoP, interview data, and clinical expertise. Members of the International Psycho-Oncology Society (IPOS) Special Interest Group FORwards with expertise in FoP in people with advanced cancer and systemic treatment were invited to score features in a 2-round modified Delphi study. Features were scored on a 5-point Likert scale indicating their importance as a feature of FoP and reached consensus to be included or excluded if more than two-thirds applied the same score. A list of agreed features of FoP was generated. Results: A total of 21 participants completed both Delphi rounds, including psychologists, researchers, nurses, and one psychiatrist. Of the 55 rated features, 31 features reached consensus to be features of FoP in advanced cancer, including items on fear, uncertainty, worry, loss, hopelessness, and interference with daily life. Conclusions: Reaching expert consensus is a critical first step in identifying features of FoP in people with advanced cancer and systemic treatment, highlighting uncertainty and fear of death as unique challenges. Identifying features of FoP in advanced cancer is essential to guide future psycho-oncological research and clinical practice to improve psychosocial guidance with FoP for the growing group of people with advanced cancer and systemic treatment.

Abstract Background: Patients with colorectal cancer (CRC) may experience symptoms of adjustment disorder (AD) after cancer diagnosis and treatment. Time-limited symptoms of AD may become persistent if the stressor or its consequences have not disappeared after 6 months, but evidence on the course of AD symptoms is scarce. This longitudinal observational study investigates the proportion of patients with CRC with time-limited and persistent AD symptoms within the first year after diagnosis, in relation to demographic, clinical, and psychological factors and health-related quality of life (HRQoL). Methods: Informed consent was retrieved from 232 participants, and 194 participants completed questionnaires at baseline, 3, 6, and 12 months postdiagnosis. Hospital Anxiety and Depression Scale total scores (HADS-T) were categorized as indication for no symptoms of a mental disorder (MD) (HADS-T ≤10), AD symptoms (HADS-T 11–14), and other MD symptoms (HADS-T ≥15). Symptom subgroups over time were a priori defined: no MD, time-limited AD, persistent AD, other MD, and fluctuating symptoms. Results: Complete data were available for 81 participants (41.4%). Over time, 38.3% had no MD symptoms, 8.6% had time-limited AD symptoms, 1.2% had persistent AD symptoms, 4.9% had other MD symptoms, and 46.9% had fluctuating symptoms. Participants with AD and fluctuating symptoms reported higher fear of cancer recurrence, lower HRQoL, and higher cancer-specific distress than participants without MD symptoms (P < .5). Conclusions: During the first year after CRC diagnosis, only a small proportion of the patients showed time-limited and persistent AD symptoms and most showed fluctuating symptoms. More prospective research is needed to determine how repeated assessments for elevated AD symptoms relate to an AD diagnosis established with a diagnostic interview.

OBJECTIVE:Colorectal cancer survivors (CRCS) often experience high levels of distress. The objective of this randomized controlled trial was to evaluate the effect of blended cognitive behavior therapy (bCBT) on distress severity among distressed CRCS. METHODS:CRCS (targeted N = 160) with high distress (Distress Thermometer ≥5) between 6 months and 5 years post cancer treatment were randomly allocated (1:1 ratio) to receive bCBT, (14 weeks including five face-to-face, and three telephone sessions and access to interactive website), or care as usual (CAU). Participants completed questionnaires at baseline (T0), four (T1) and 7 months later (T2). Intervention participants completed bCBT between T0 and T1. The primary outcome analyzed in the intention-to-treat population was distress severity (Brief Symptom Inventory; BSI-18) immediately post-intervention (T1). RESULTS:84 participants were randomized to bCBT (n = 41) or CAU (n = 43). In intention-to-treat analysis, the intervention significantly reduced distress immediately post-intervention (-3.86 points, 95% CI -7.00 to -0.73) and at 7 months post-randomization (-3.88 points, 95% CI -6.95 to -0.80) for intervention compared to CAU. Among secondary outcomes, at both time points, depression symptoms, anxiety symptoms, cancer worry, and cancer-specific distress were significantly lower in the intervention arm. Self-efficacy scores were significantly higher. Overall treatment satisfaction was high (7.4/10, N = 36) and 94% of participants would recommend the intervention to other colorectal cancer patients. CONCLUSIONS:The blended COloRectal canceR distrEss reduCTion intervention seems an efficacious psychological intervention to reduce distress severity in distressed CRCS. Yet uncertainty remains about effectiveness because fewer participants than targeted were included in this trial. TRIAL REGISTRATION:Netherlands Trial Register NTR6025.