Fear of cancer recurrence in adolescent and young adult cancer survivors: <scp>A</scp> systematic review of the literature

Yang, Yuan; Li, Wen; Wen, Yunhong; Wang, Hongmei; Sun, Hengwen; Liang, Wenjie; Zhang, Bin; Humphris, Gerry

doi:10.1002/pon.5013

Cited by 87 publications

(77 citation statements)

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“…Between 69 and 75% reported some degree of FCR and approximately 20% reported quite a bit or a lot of worry concerning disease recurrence or getting another cancer in this large population of long-term survivors. Previous studies on Table 2 Fear of cancer recurrence (FCR) in the total sample, according to diagnostic group and cancer worry item in the Assessment of Survivorship Concern (ASC) Scale, and as a summed score, in total and according to diagnostic group ASC item N (%) MM 1 (%) BC 2 (%) CRC 3 (%) NHL 4 (%) LEU 5 3 Colorectal cancer 4 Non-hodgkin lymphoma 5 Leukemia 6 3 missing values for this item 7 1 missing value for this item 8 Standard deviation 9 Confidence interval FCR among AYA cancer survivors, which typically have shorter observation times, report prevalence estimates in the range of 31-85% [7,11]. The heterogeneity of both samples and FCR measures used makes comparison across studies challenging.…”

Section: Discussionmentioning

confidence: 99%

Fear of cancer recurrence among young adult cancer survivors—exploring long-term contributing factors in a large, population-based cohort

et al. 2020

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Purpose Fear of cancer recurrence (FCR) may be debilitating, yet knowledge of FCR among the growing population of long-term young adult cancer survivors (YACS) is scarce. We explored risk of FCR and associated factors in a nation-wide, population-based cohort of YACS. Methods All 5-year survivors diagnosed at the ages of 19–39 years with breast cancer (BC), malignant melanoma (MM), colorectal cancer (CRC), leukemia (LEU), or non-Hodgkin lymphoma (NHL) between 1985 and 2009 in Norway were identified by the Cancer Registry of Norway and completed the cross-sectional comprehensive NOR-CAYACS health survey. Univariate and multivariate linear regression modeling was performed. Results In total, 936 survivors were included, with an average of 16 years since diagnoses. BC was the most prevalent cancer form (38.4%), followed by MM (24.7%), NHL (15.6%), CRC (11.8%), and LEU (9.6%). Survivors worried most about getting another cancer (74%), and (20%) reported quite a bit or a lot of FCR. BC and MM survivors had the highest FCR scores. Post-traumatic stress symptoms (PTSS) had the strongest association with FCR (Std B 0.21, p < 0.01), above demographic and clinical variables. Conclusions FCR is prevalent even among long-term YACS, including survivors of MM with favorable prognoses. Implications for Cancer Survivors Attention to ongoing risks of PTSS and FCR in this growing survivor population is warranted to optimize future survivorship care.

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Section: Discussionmentioning

confidence: 99%

Fear of cancer recurrence among young adult cancer survivors—exploring long-term contributing factors in a large, population-based cohort

et al. 2020

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“…110 Fear of recurrence is also high, with up to 62% reporting elevated worry. 112 Notably, distress symptoms have been found to persist beyond treatment completion, with the highest levels documented within the first 2 years after treatment completion. 113 It is also important to note that, given the timing of their diagnosis, symptoms of distress may fluctuate and coincide with key developmental milestones affected by cancer.…”

Section: Transitioning Into Post-treatment Survivorship: Addressing Pmentioning

confidence: 99%

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

Perez

Salsman

Fladeboe

et al. 2020

American Society of Clinical Oncology Educational Book

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Research on adolescents and young adults (AYAs) with cancer has flourished over the past decade, underscoring the unique medical and psychosocial needs of this vulnerable group. A cancer diagnosis during adolescence and young adulthood intersects with the developmental trajectory of AYAs, derailing critical physical, social, and emotional development. AYAs face these abrupt life changes needing age-appropriate information and resources to offset these challenges. Greater attention is needed to address AYA-specific concerns on reproductive and sexual health, financial security and independence, emotional well-being, social support, and end-of-life care. If these unique needs are unaddressed, this can adversely affect AYAs’ health care engagement and overall quality of life, increasing their risk for cancer-related morbidity and early mortality. In particular, health care decisions made during treatment have important implications for AYA patients’ future health. Oncology clinicians are well positioned to address AYA patients’ concerns by anticipating and addressing the challenges this age group is likely to face. In this paper, we explore several core topics that affect AYAs’ quality of life and that can be challenging to address. Starting from the moment of diagnosis, through cancer treatment and post-treatment survivorship, and into end of life, each section highlights critical developmental-centric life domains that are affected by the cancer experience. Specifically, we discuss resources, tools, and strategies to navigate these challenging conversations. Taking a risk-reduction approach that invites two-way communication and facilitates referral to age-appropriate resources would help destigmatize these experiences and, in turn, would support the provision of compassionate and effective age-concordant care to this vulnerable group.

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“…As well, multiple studies have found that younger women are more prone to high FCR than older women . Elevated FCR in young people is associated with lower physical and psychological functioning and lower overall quality of life . Due to its far‐reaching consequences, it is important to adequately screen for FCR with scales that are both psychometrically sound and practical to use in a clinical setting.…”

Section: Introductionmentioning

confidence: 99%

The FCR‐1: Initial validation of a single‐item measure of fear of cancer recurrence

et al. 2020

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Objective: Fear of cancer recurrence (FCR) is characterized by the fear, worry or concern that cancer will come back or progress. The negative effects associated with FCR are consistently identified by cancer survivors as one of their most prominent unmet needs. Current measures of FCR can be long, complex and burdensome for survivors to complete. The objective of the present study is to develop and validate a one-item measure of FCR.Methods: The ability of the FCR-1 to detect change in FCR over time was analyzed using a repeated-measures ANOVA and paired-samples t-tests. Pearson correlations were used to measure the concurrent, convergent and discriminant validity of the FCR-1, and a ROC analysis was conducted to determine an optimal clinical cut-off score.Results: The FCR-1 was found to be responsive to change in FCR over time. It demonstrated concurrent validity with the FCRI (r = .395, P = .010), and convergent validity with the Mishel Uncertainty in Illness Scale (r = .493, P = .001) and the Reassurance Questionnaire (r = .325, P = .044). Discriminant validity was confirmed when the FCR-1 did not significantly correlate with unrelated measures. A ROC analysis pinpointed an optimal clinical cut-off score of 45.0. Conclusions:The FCR-1 is a promising tool that can be incorporated in clinical and research settings. Due to its brevity, the care needs of highly distressed patients can be met quickly and efficiently. In research settings, the FCR-1 can reduce the cognitive burden experienced by survivors. K E Y W O R D S breast cancer, cancer, fear of cancer recurrence, oncology, psycho-oncology, scale development, single-item measure, survivors, unmet needs, validation | BACKGROUNDAlthough nearly half of all Canadian women will be diagnosed with cancer during their lifetime, the majority of these women will survive their cancer due to early detection and advanced treatment options. 1 Despite good prognosis, many of these women will experience fear of cancer recurrence (FCR). At a 2-day colloquium at the University of Ottawa in 2015, researchers consensually defined FCR as the "fear, worry, or concern relating to the possibility that cancer will come back or progress." 2 FCR is very common, especially at the end of treatment; studies have demonstrated that it can affect anywhere between 22% and 96% of cancer survivors. 2-4 Survivors consistently include FCR in their top health-related concerns, and frequently identify help regarding FCR as one of their most prominent unmet needs in healthcare settings. 4-6 29:788-795. wileyonlinelibrary.com/journal/pon 4 | RESULTS | ResponsivenessOnly participants with FCR-1 scores at all 6 timepoints (n = 29) were included in the RM ANOVA analysis. The FCR-1 means at each session are summarized in Table 2. A repeatedmeasures ANOVA with a Greenhouse-Geisser correction was used as sphericity could not be assumed. The mean scores for FCR were statistically significantly different (F[3.425, 95.903] = 4.026, P = .007, η 2 = .126). Paired sample ttests were conducted to examine the dif...

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Fear of cancer recurrence in adolescent and young adult cancer survivors: A systematic review of the literature

Cited by 87 publications

References 61 publications

Fear of cancer recurrence among young adult cancer survivors—exploring long-term contributing factors in a large, population-based cohort

Fear of cancer recurrence among young adult cancer survivors—exploring long-term contributing factors in a large, population-based cohort

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

The FCR‐1: Initial validation of a single‐item measure of fear of cancer recurrence

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