Fear of cancer recurrence among survivors of childhood cancer

Abstract

ObjectivesFear of cancer recurrence (FCR) has not been widely explored in survivors of childhood cancer. Yet, childhood survivors are at risk of experiencing late effects and may be especially vulnerable. The aims of the current study were to conduct a retrospective chart review to determine the prevalence and persistence of FCR among survivors of childhood cancer and to examine factors that may be related to FCR.MethodsSurvivors of childhood cancer (n = 228, mean attained age = 14.5 years [range = 4.7‐21 years]; mean diagnosis age = 4.4 years [range = 0‐16.5 years]; mean time off treatment = 8.7 years [range = 2.8‐19.3 years]) seen in a Long‐Term Survivor Clinic (LTSC) completed questionnaires at each clinic visit detailing their current health. FCR was measured with a single item. Data from questionnaires from 2011 to 2018 were analyzed retrospectively. Descriptive statistics and a random effects model were used to address study aims.ResultsFCR was reported in 43% (n = 98) of survivors at least once across all clinic visits. Among survivors reporting FCR at least once, 66% were diagnosed with cancer under the age of 5, and 64% were 13 years or older at their most recent follow‐up. Twenty‐one percent of survivors (n = 48/224) reported FCR during at least 50% of their visits. Survivors with a higher number of depressive symptoms were more likely to report FCR (OR = 1.66, P = .03).ConclusionsFCR is prevalent among survivors of childhood cancer and is related to other health concerns. Research is needed to understand who is at risk and how to.

Worry about somatic symptoms as a sign of cancer recurrence: prevalence and associations with fear of recurrence and quality of life in survivors of childhood cancer

“…Beyond these central findings, this study extends the current literature on fear of cancer recurrence. The two published studies in pediatric samples both use single, unvalidated items to assess fear of recurrence 9,35 . We present the first data using a comprehensive measure of fear of recurrence that is well‐validated in adult populations, although it requires more extensive validation in pediatric populations.…”

“…Fear of cancer recurrence, defined as “the fear, worry or concern relating to the possibility that cancer will come back or progress” 8 is among the most prevalent and distressing concerns reported by survivors of all ages 9–11 . Some degree of fear of recurrence is common after cancer.…”

“…Yet, a significant minority of survivors report high fear of cancer recurrence that persists over time, increases healthcare utilization, and impairs functioning 11,12 . Younger age is the most consistent statistical predictor of elevated fear of recurrence across studies in adults, 10 and recent findings indicate that SCCs also experience fear of recurrence that is linked with more depressive symptoms 9 . In addition, theoretical models of fear of cancer recurrence 5,13 propose that somatic symptoms can trigger fear, indicating that symptom worry may be an important target for interventions aiming to reduce fear of recurrence.…”

Fear of cancer recurrence in childhood cancer survivors: A developmental perspective from infancy to young adulthood

“…To date and to the best of our knowledge, only two published studies have quantitatively examined FCR in pediatric samples. In the first study, Wroot and colleagues 9 reported that 43% of childhood cancer survivors endorse fear about the possibility of their cancer returning. In a subsequent study, Koutná and colleagues 10 found that FCR was positively associated with both symptoms of post‐traumatic stress and post‐traumatic growth in children.…”

Mother–child communication about possible cancer recurrence during childhood cancer survivorship

“…Further, data suggest that FCR is higher among survivors of childhood cancer than among survivors of adult cancer 4 . In survivors of childhood cancer, higher FCR is associated with a range of difficulties that include impaired psychological functioning, poor health‐related quality of life, greater healthcare utilization, and maladaptive health behaviors 5–8 . There is a critical need for more research on FCR in childhood cancer survivors to guide targeted intervention.…”