Factors reported to influence fear of recurrence in cancer patients: a systematic review

Abstract

Objective: Fear of cancer recurrence (FCR) is a significant psychological problem for cancer survivors. Some survivors experience FCR, which is both persistent and highly distressing. The aim of this systematic review was to identify the key factors associated with fear of recurrence among cancer patients.Methods: A comprehensive literature search using keywords was performed with three databases, followed by an organic search to identify additional relevant articles. Included studies had a quantitative methodology presenting empirical findings focussed on adult cancer patients. A methodological quality assessment was performed for each study, and the strength of evidence was defined by the consistency of results.Results: Forty-three studies met the inclusion criteria and are presented in this review. The most consistent predictor of elevated FCR was younger age. There was strong evidence for an association between physical symptoms and fear of cancer recurrence. Additional factors moderately associated with increased FCR included treatment type, low optimism, family stressors and fewer significant others. Inconsistent evidence was found for socio-demographic factors.Conclusions: Fear of cancer recurrence is a complex issue influenced by a multitude of factors, including demographic, clinical and psychological factors. However, some studies have reported contradictory evidence, and FCR has been measured using a range of scales, which can hamper comparison across studies. Further research is needed to clarify inconsistencies in the current published research.

Fear of recurrence and its impact on quality of life in patients with hematological cancers in the course of allogeneic hematopoietic SCT

“…Moreover, the cancer diagnosis and the information about necessary treatments are associated with high psychological stress, which again is significantly correlated with FCR. 12,22 However, corresponding to previous repeatedly replicated findings, we did not found a significant association between FCR and cancer diagnosis. 3,4,[22][23][24][25] A further aim of this study was to identify high-risk baseline predictors for FCR before and after allogeneic PBSC transplantation.…”

“…FCR is defined as the fear or worry that cancer will return, progress or metastasize. [3][4][5][6][7] FCR is often conceptualized as a multidimensional phenomenon, including emotional components of anxiety and fear, and a cognitive dimension, including worry, preoccupation and intrusive thoughts. 3,8,9 Prevalence estimates of FCR range between 22 and 99% among cancer survivors and FCR is considered to be one of the most distressing psychological consequences of cancer.…”

Psychological Adjustment in Breast Cancer Survivors

“…Heightened fear of recurrence is reported by adult survivors of younger age, lower educational level, fewer signifi cant others, and Hispanic or non-Hispanic white race/ethnicity ( Crist and Grunfeld 2013 ;Phillips et al 2013 ). Lower optimism and social support, more family stressors, depressive symptoms, pain, and other physical symptoms also are linked to higher fear (Crist and Grunfeld 2013 ;Phillips et al 2013 ).…”

A single-item screening question for fear of recurrence in head and neck cancer

“…Fear of recurrence (FoR) is described as 'the fear associated with the possibility the cancer will return or progress in the same or another part of the body' [1]. Fear of recurrence is a significant psychological problem and rates of up to 65 % have been reported [2]. It is the most frequent issue patients wish to raise in review consultations [3,4].…”

“…This is not unexpected as patients face considerable uncertainty and daily challenges of living with and beyond head and neck cancer (HNC) [5]. Although FoR is a complex issue influenced by a multitude of factors, including demographic, clinical and psychological factors [2], there is a body of consistent evidence developing in the literature specific to HNC [5][6][7][8][9][10][11].…”