The Concerns About Recurrence Questionnaire: validation of a brief measure of fear of cancer recurrence amongst Danish and Australian breast cancer survivors

Thewes, Belinda; Zachariae, Robert; Christensen, Søren; Nielsen, Tine; Butow, Phyllis

doi:10.1007/s11764-014-0383-1

Cited by 59 publications

(71 citation statements)

References 31 publications

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“…Similar results have been found in large sample of Danish and Australian survivors (7-9 years after diagnosis) treated for breast cancer (N ¼ 1885) which further indicating that FCR generally remains stable over the survivorship trajectory [15]. The systematic review showing predictors of having FCR as age, time since primary surgery, surgery type, treatment type, having symptoms of pain, depression, fatigue, and unmet needs [14].…”

supporting

confidence: 73%

“…In a sample of Australian and Danish breast cancer patients the CARQ-4 has shown to be reliable and valid [15]. Furthermore, a Rasch analysis identified item bias relative to age [15].…”

Section: Methodsmentioning

confidence: 91%

“…In Item 4, the perceived risk of recurrence is scored as a number (up to 100%). A cutoff score !12 has been shown to indicate clinical FCR [15]. In a sample of Australian and Danish breast cancer patients the CARQ-4 has shown to be reliable and valid [15].…”

Section: Methodsmentioning

confidence: 97%

“…The four-item CARQ-4 has previously been adapted into Danish and assesses three different aspects of FCR and the perceived risk of recurrence [15]. Item 1-3 are rated on an 11-point Likert scale ('not at all' to 'a great deal').…”

Section: Methodsmentioning

confidence: 99%

“…A single reminder, together with a new copy of the questionnaire, was mailed out after two weeks. The questionnaire package included the questionnaires CaSUN [16] and Concerns About Recurrence of Cancer (CARQ-4) [15], together with questions concerning breast cancer-related side effects, late effects, and psychosocial problems.…”

Section: Patients and Proceduresmentioning

confidence: 99%

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Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study

et al. 2017

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Background: It is unclear to which degree the services available after end of treatment are sufficient to meet the needs of women treated for breast cancer. The aim of the present study was to identify patient-reported supportive care needs and the prevalence of fear of cancer recurrence (FCR) following end of treatment in women treated for breast cancer. Material and methods: Using a cross-sectional design, women treated for breast cancer (n ¼ 155; mean age 63) completed questionnaires concerning supportive care needs and FCR. Inclusion criteria were: !18 years of age and treated for primary breast cancer at Aarhus University Hospital, Aarhus, Denmark and between three months and five years after diagnosis. Associations between demographic characteristics, clinical factors, side effects, late effects and the two dependent variables, unmet needs (examined with linear regression model), and FCR (examined with logistic regression model) were analyzed. Results: The response rate was 79.9%. Almost all (82.6%) women reported at least one unmet need (mean number 9.3; range 0-34). More than half (59.3%) of the unmet needs were rated as strong unmet needs. The most frequent unmet needs were concerned with doctors collaborate to coordinate care; the need for having ongoing dialog with healthcare providers to receive available local health care services, understandable and up-to-date information, to manage side effects and feeling reassured that the best medical care are given. Having unmet needs were associated with young age, short time since primary surgery, and having clinical FCR. FCR was reported by 54.8% of the women and was associated with short time since primary surgery, having chemotherapy, having unmet needs, and moderate to severe muscle and joint pain and fatigue. Conclusions: Breast cancer survivors experience substantial unmet needs years after end of treatment, particularly among younger women and women having clinical FCR. Furthermore, FCR is frequent among women, particularly when closer in time to primary surgery.

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supporting

confidence: 73%

“…In a sample of Australian and Danish breast cancer patients the CARQ-4 has shown to be reliable and valid [15]. Furthermore, a Rasch analysis identified item bias relative to age [15].…”

Section: Methodsmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Patients and Proceduresmentioning

confidence: 99%

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Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study

et al. 2017

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Assessment of the Value of Tumor Variation Profiling Perceived by Patients With Cancer

et al. 2020

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IMPORTANCEUse of tumor molecular profiling (MP) is entering routine clinical practice; however, little is known about how much and why patients value MP. OBJECTIVE To examine the perceived value of MP to patients with advanced cancer and factors associated with perceived value. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional survey that included willingness-to-pay trade-off scenarios was administered to participants after consent and before MP. A total of 777 participants (94% response rate) were recruited from the Molecular Screening and Therapeutics Program. Eligible patients had advanced solid cancers of any histologic type, were receiving or had completed their last line of effective therapy, had an Eastern Cooperative Oncology Group

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Effect of a Nurse Navigation Intervention on Mental Symptoms in Patients With Psychological Vulnerability and Breast Cancer

et al. 2023

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ImportanceThe unmet needs regarding symptom management of psychological distress among patients with breast cancer must be addressed. However, little evidence exists on effective interventions, such as nurse navigation.ObjectiveTo compare the long-term effects of the REBECCA (Rehabilitation After Breast Cancer) nurse navigation intervention vs usual care in patients with breast cancer who were psychologically vulnerable.Design, Setting, and ParticipantsThis parallel randomized clinical trial recruited and evaluated for eligibility adult female patients with newly diagnosed breast cancer and symptoms of psychological distress (distress score of ≥7 points on Distress Thermometer) at Rigshospitalet in Copenhagen, Denmark, from August 2017 to October 2019. This study continued the work of a pilot study, extending the follow-up to 18 months. Patients who met the inclusion criteria were randomized to either standard care or the REBECCA intervention. Intention-to-treat analyses were performed from June 2021 to October 2022.InterventionsPatients who were randomized to the REBECCA intervention received nurse navigation and symptom screening as well as standard care. Standard care included regular treatment, nurse support at chemotherapy and radiotherapy appointments, and municipality-based rehabilitation.Main Outcomes and MeasuresThe primary outcome was distress, as measured using the Distress Thermometer. The secondary outcomes included symptoms of anxiety, symptoms of depression, breast cancer–specific health-related quality of life, fear of recurrence, sleep, cognitive function, patient activation, pain, health behavior, body mass index, and need for support. Long-term effects at 6, 12, and 18 months were examined using mixed-effect models, adjusting for randomization strata of age and treatment modality.ResultsA total of 309 female patients were included in the analysis, with 153 patients randomized to the standard care group and 156 patients randomized to the REBECCA intervention group. Mean (SD) age was 56 (11) years with only small between-group differences. Patients receiving the REBECCA intervention compared with standard care had reduced (although not significant) symptoms of distress, especially at the 12-month follow-up (estimated effect = −0.51 [95% CI, −1.05 to 0.04]; effect size [ES] = −0.49). Significant effects were seen for symptoms of depression at 6 months (estimated effect = −1.39 [95% CI, −2.33 to −0.44]; ES = −0.27), and breast cancer–specific health-related quality of life at 12 months (estimated effect = 4.03 [95% CI, 1.28- 6.77]; ES = 0.31). Nonsignificant reductions were seen for symptoms of anxiety at 6 months (estimated effect = −1.00 [95% CI, −1.95 to −0.06]; ES = −0.21) and 12 months (estimated effect = −1.01 [95% CI, −1.97 to −0.04]; ES = −0.21), and a nonsignificant increase was seen for patient activation at 18 months (estimated effect = 3.52 [95% CI, −0.09 to 7.12]; ES = 0.25). Stronger intervention effects were observed for younger age, low patient activation, less education, and low social support.Conclusions and RelevanceResults of this study indicate that patients with breast cancer who were psychologically vulnerable (ie, having moderate to high psychological distress) did not experience significant reduction in distress with nurse navigation. Further research is needed to develop the intervention’s framework and investigate its potential use in clinical practice.Trial RegistrationClinicalTrials.gov Identifier: NCT03254875

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The Concerns About Recurrence Questionnaire: validation of a brief measure of fear of cancer recurrence amongst Danish and Australian breast cancer survivors

Abstract: The availability of more valid and reliable brief measures of FCR will help to promote research and screening of FCR amongst cancer survivors.

Cited by 59 publications

References 31 publications

Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study

Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study

Assessment of the Value of Tumor Variation Profiling Perceived by Patients With Cancer

Effect of a Nurse Navigation Intervention on Mental Symptoms in Patients With Psychological Vulnerability and Breast Cancer

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