Fear of Cancer Recurrence, Health Anxiety, Worry, and Uncertainty: A Scoping Review About Their Conceptualization and Measurement Within Breast Cancer Survivorship Research

Abstract

Objective: Fear of Cancer Recurrence (FCR), Health Anxiety (HA), worry, and uncertainty in illness are psychological concerns commonly faced by cancer patients. In survivorship research, these similar, yet different constructs are frequently used interchangeably and multiple instruments are used in to measure them. The lack of clear and consistent conceptualization and measurement can lead to diverse or contradictory interpretations. The purpose of this scoping review was to review, compare, and analyze the current conceptualization and measurements used for FCR, HA, worry, and uncertainty in the breast cancer survivorship literature to improve research and practice.Inclusion Criteria: We considered quantitative, qualitative, and mixed methods studies of breast cancer survivors that examined FCR, HA, worry, or uncertainty in illness as a main topic and included a definition or assessment of the constructs.Methods and Analysis: The six-staged framework was used to guide the scoping review process. Searches of PubMed, CINAHL, and PsycINFO databases were conducted. The principle-based qualitative analysis and simultaneous content analysis procedures were employed to synthesize and map the findings.Findings: After duplicate removal, the search revealed 3,299 articles, of which 82 studies met the inclusion criteria. Several critical attributes overlapped the four constructs, for example, all were triggered by internal somatic and external cues. However, several unique attributes were found (e.g., a sense of loss of security in the body is observed only among survivors experiencing FCR). Overall, findings showed that FCR and uncertainty in illness are more likely to be triggered by cancer-specific factors, while worry and HA have more trait-like in terms of characteristics, theoretical features, and correlates. We found that the measures used to assess each construct were on par with their intended constructs. Eighteen approaches were used to measure FCR, 15 for HA, 8 for worry, and 4 for uncertainty.Conclusion: While consensus on the conceptualization and measurement of the four constructs has not yet been reached, this scoping review identifies key similarities and differences to aid in their selection and measurement. Considering the observed overlap between the four studied constructs, further research delineating the unique attributes for each construct is warranted.

The impact of COVID-19 on cancer patients, their carers and oncology health professionals: A qualitative study

“…Participants in this study noted significant uncertainty in relation to COVID-19 and its potential impacts on current and future cancer treatment, compounding existing cancer-related uncertainties [31] , [32] . HPs described a sense of kinship with their patients over these shared uncertainties.…”

Depression and Anxiety - Risk Factors in the Evolution of Breast Cancer in Women

“…The intensification of anxiety symptoms is determined by the long duration of the diagnostic uncertainties regarding breast cancer, but also by the prospect of an unfavorable evolution that would require radical surgeries such as mastectomy with or without ovarectomy, as well as chemotherapy and radiotherapy (Maheu et al, 2021). The general psychological evaluation performed before the first suspicions of neoplastic breast disease may give the clinician and psychooncologist data on the presence or absence of anxious personality traits (Stark & House, 2000).…”

Attentional bias toward health-threat in health anxiety: a systematic review and three-level meta-analysis

“…Second, Google Scholar (the first five pages) was searched for eligible studies (using the same terms). Third, the reference lists of selected papers and relevant review articles (Leonidou & Panayiotou, 2018; Maheu et al, 2021; Vismara et al, 2020) were checked to identify additional studies.…”