Medical, demographic and psychological correlates of fear of cancer recurrence (FCR) morbidity in breast, colorectal and melanoma cancer survivors with probable clinically significant FCR seeking psychological treatment through the ConquerFear study

Smith, Allan Ben; Sharpe, Louise; Thewes, Belinda; Turner, Jane; Gilchrist, Jemma; Fardell, Joanna E.; Girgis, Afaf; Tesson, Stephanie; Descallar, Joseph; Bell, Melanie L.; Beith, Jane; Butow, Phyllis

doi:10.1007/s00520-018-4294-y

Cited by 34 publications

(52 citation statements)

References 31 publications

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“…Consistent with previous evidence, our study showed that FCR was only weakly associated with demographic and clinical characteristics, and these associations disappeared when psychological factors were introduced into the multivariable analysis. Physical symptom distress also had little effect differentiating FCR status, possibly because of the choice of the assessment time point.…”

Section: Discussionsupporting

confidence: 91%

“…Beliefs about worry significantly differentiated FCR status. Subclinical or clinical FCR patients tended to hold greater negative beliefs about worry (worry about worry), consistent with previous studies on metacognition and FCR, but only subclinical FCR patients were more likely to perceive worry as beneficial, suggesting some qualitative rather than purely quantitative differences between subclinical and clinical FCR. The evidence linking positive belief about worry and FCR is mixed .…”

Section: Discussionsupporting

confidence: 87%

“…Subclinical or clinical FCR patients tended to hold greater negative beliefs about worry (worry about worry), consistent with previous studies on metacognition and FCR, but only subclinical FCR patients were more likely to perceive worry as beneficial, suggesting some qualitative rather than purely quantitative differences between subclinical and clinical FCR. The evidence linking positive belief about worry and FCR is mixed . Our study is the first to differentiate subclinical from clinically significant FCR, with subclinical FCR patients apparently perceiving worry as more beneficial, potentially reinforcing use of worry as a distress management strategy, whereas patients with clinically significant FCR appear to hold generally negative beliefs.…”

Section: Discussionsupporting

confidence: 87%

“…Similarly, positive associations of FCR with maladaptive metacognition were reported in another study of young women with breast cancer (BC) . In a sample of breast, colorectal, and melanoma cancer survivors, negative metacognitive beliefs about worry and intrusive thought correlated with FCR after adjusting for demographic and medical factors …”

Section: Introductionmentioning

confidence: 57%

“…Their associations with FCR generally disappear in multivariate analyses suggesting a minor role in FCR . Younger age seems somewhat related, but psychological factors predominantly determine FCR. One potential mechanism involves maladaptive information processing styles .…”

Section: Introductionmentioning

confidence: 93%

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Fear of cancer recurrence among Chinese cancer survivors: Prevalence and associations with metacognition and neuroticism

Kwong

Suen

et al. 2019

Psycho-Oncology

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Objective Fear of cancer recurrence (FCR) represents a chronic burden for many cancer survivors. We determined FCR prevalence and potential correlates, specifically metacognitive styles and neuroticism among Chinese cancer survivors with breast or colorectal cancer. Methods This study included 285 Chinese patients with breast (N = 173) and colorectal (N = 112) cancers at 8‐week postsurgery. Participants completed a set of baseline questionnaires evaluating FCR (Fear of Cancer Recurrence Inventory‐Short Form [FCRI‐SF]), metacognition (Metacognitions Questionnaire‐30), and neuroticism (Eysenck Personality Questionnaire). Scores of 13 to 21 were indicative of subclinical FCR on the FCRI‐SF. Scores greater than or equal to 22 indicated clinically significant levels of FCR. Fully adjusted multinomial logistic regressions identified correlates of subclinical and clinically significant FCR. Results Respectively, 26.0% (n = 74) and 11.2% (n = 32) achieved scores indicating subclinical and clinically significant FCR. Expressing significantly more positive (OR = 1.21, P = .003) and negative (OR = 1.19, P = .005) beliefs about worry was associated with a higher likelihood of reporting subclinical FCR. Both higher neuroticism (OR = 1.28, P = .003) and more negative beliefs about worry (OR = 1.19, P = 0.035) were associated with an increased likelihood of experiencing clinically significant FCR. Conclusions Positive and negative metacognitions may play an important role in the development of subclinical FCR. In particular, negative metacognition and neuroticism may elevate FCR from subclinical to a clinical level. The findings give insight into the identification of cancer survivors with subclinical or clinical FCR and aid the development of interventions aimed at changing metacognitive beliefs in order to manage FCR.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 93%

See 3 more Smart Citations

Fear of cancer recurrence among Chinese cancer survivors: Prevalence and associations with metacognition and neuroticism

Kwong

Suen

et al. 2019

Psycho-Oncology

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

Yang

Li²,

Wen

et al. 2019

Psycho-Oncology

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Objective The current systematic review aims to provide an overview of fear of cancer recurrence (FCR) in adolescent and young adult cancer survivors (15‐39 years at cancer diagnosis, AYAs). Methods MEDLINE, PubMed, PsycINFO, and Embase databases were independently searched to identify relevant quantitative articles. PRISMA systematic review procedures were followed with quality assessment. Results Seventeen studies were included in the current review. All were quantitative studies that utilized a cross‐sectional study design. Seven articles reported results of FCR prevalence, six studied determinants related to FCR, and 11 articles provided information about consequences of FCR. Prevalence of FCR ranged from 31% to 85.2% among AYA survivors. Associations between sociodemographic/clinical variables and FCR were inconsistent. Psychological distress and higher treatment intensity were positively associated with higher FCR levels. Lower scores on levels of physical, psychological functioning, and overall health‐related quality of life (QoL) were identified as consequences of increased FCR. Conclusion FCR appears to be a prevalent concern among adolescent and young adult cancer populations. Adequate assessment to determine need for support and intervention is still required. Longitudinal studies in AYAs are warranted to understand the development and potential influence of FCR. Age‐appropriate and flexible psychological care would be more successful potentially with this crucial background information.

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A research agenda for fear of cancer recurrence: A Delphi study conducted in Australia

et al. 2019

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Objective: Fear of cancer recurrence (FCR) is common, debilitating, and costly to the health system. While there has been a rising trajectory in FCR-related research, there remain many unanswered questions. A research agenda is required to clarify priorities and ensure that research dollars and effort are expended wisely. This study aimed to elicit research topics and priorities from clinical and academic experts in FCR.Methods: Phase 1 consisted of elicitation by survey of prioritised FCR research topics from 20 members of the Psycho-Oncology Co-operative Research Group (PoCoG) FCR special interest group, followed by a focus group discussion with 28 clinicians, researchers, and cancer survivors, at which survey results were presented and further reflection was encouraged. This resulted in 28 research topics that were then subjected to a Delphi process to establish consensus (phase 2).Results: Thirty-one participants completed round 1 of the Delphi process and 23 round 2, after which satisfactory consensus was reached. Five broad areas of research were identified as priorities. In rank order, they were (1) intervention models; (2) definition, predictors, and outcomes of FCR; (3) detection and screening;(4) training for health professionals; and (5) reaching specific populations.Conclusions: It is hoped that the current findings will guide FCR researchers towards clinically relevant, significant research that will move the field forward.Experts nominated intervention research as the top priority, specifically exploring optimal formats of delivery including stepped care and blended models incorporating online or phone elements to increase accessibility. KEYWORDS cancer, Delphi method, fear of cancer recurrence, oncology, research priorities 1 | INTRODUCTION Fear of cancer recurrence (FCR), defined as "fear, worry or concernrelating to the possibility that cancer will come back or progress," 1(p3266) is pervasive among cancer survivors. While some degree of FCR among cancer survivors is considered normal, 1 approximately 50% experience moderate to high FCR levels. 2 High FCR does not appear to diminish over time and is associated with greater psychological distress, impaired quality of life, and increased health care utilisation. 2 While FCR overlaps with other forms of psychological distress, FCR is often an isolated focus of worry in otherwise mentally well individuals. 3 Up to 79% of survivors report an unmet need for

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Medical, demographic and psychological correlates of fear of cancer recurrence (FCR) morbidity in breast, colorectal and melanoma cancer survivors with probable clinically significant FCR seeking psychological treatment through the ConquerFear study

Cited by 34 publications

References 31 publications

Fear of cancer recurrence among Chinese cancer survivors: Prevalence and associations with metacognition and neuroticism

Fear of cancer recurrence among Chinese cancer survivors: Prevalence and associations with metacognition and neuroticism

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

A research agenda for fear of cancer recurrence: A Delphi study conducted in Australia

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