Onco-anxiology: a proposal for an anxiety-focused, longitudinal framework within cancer care

Background Anxiety is among the most common forms of psychological distress in people with cancer, yet in routine practice it is usually addressed within a broad “distress” construct rather than as a distinct clinical target. Objective This Perspective examines whether anxiety warrants a dedicated, longitudinally organised clinical focus, and proposes onco-anxiology as such a framework within psycho-oncology. Key points Anxiety in cancer is phenomenologically distinct from depression, frequently oriented toward realistic future threat such as fear of cancer recurrence, follows a patterned course at the population level, and is shaped by cancer-specific mechanisms, including conditioned anticipatory symptoms and the overlap between somatic anxiety items and treatment side effects; existing screening is generally organised around undifferentiated distress rather than anxiety specifically, and unaided clinician recognition and help uptake are limited. Onco-anxiology is defined by three commitments: anxiety-specific targeting, a longitudinal lens, and explicit attention to cancer-specific anxiety mechanisms. Physiological measurement is positioned as a research direction and an optional adjunct rather than a defining feature, and the framework is offered as a way of organising care within psycho-oncology rather than as a claim to a new sub-specialty. Conclusion A focused framework may improve identification and treatment of anxiety in oncology. The term is proposed as a testable organising concept, not an established field, and a research agenda is outlined.