The relationship between fear of cancer recurrence and health behaviors: A nationwide longitudinal study of cancer survivors.

Abstract

Objective:The goal of this study was to examine fear of cancer recurrence (FCR) and 2 health behaviors, physical activity and fruit and vegetable intake, from early to long-term survivorship in a large cohort of mixed cancer survivors. Method: Group-based trajectory analyses and repeated measures analysis of variance were conducted on data collected in the American Cancer Society's Studies of Cancer Survivorship-I. Two thousand three hundred thirty-seven survivors of 10 cancers completed the survey at 3 time points (M ϭ 1.3, 2.2, and 8.8 years postdiagnosis). Results: The current study found 3 FCR trajectories clustering cancer survivors by FCR severity: low (33.6%), moderate (58.1%), and high (8.3%). FCR significantly decreased over time and remained distinct for each trajectory group. Patient characteristics prevalent in the high FCR group were being female, of younger age, Hispanic ethnicity, having advanced cancer stage (II to III) and non-Hodgkin lymphoma, and low adherence to physical activity and fruit and vegetable intake recommendations. The high FCR group also reported significantly fewer of these health behaviors compared with the other groups, albeit the effect size was small. Conclusions: Across the survivorship trajectory, FCR severity decreased but remained distinct for the 3 trajectory groups. Future investigations should inquire about the specific needs of each FCR group to subsequently develop targeted interventions. A weak association between FCR and health behaviors was found, with individuals in the high FCR group reporting less health behaviors. Future research should assess the direction of this relationship over time to inform intervention targets within this subgroup.

Fear of Cancer Recurrence in Stomach Cancer Survivors: Exploring Socio-Demographic, Physical, Psychological and Quality of Life-Related Factors

“…Even in survivors with high FCR, lifestyle modi cation, secondary primary cancer screening, and surveillance of comorbidities were unaffected. These ndings do not support the 'teachable moment theory,' suggesting that cancer survivors who experience greater FCR are motivated to engage in health behaviors [11,35]. This theory has worked in the case of smoking cessation [36].…”

“…However, the theory does not apply to the health behaviors of cancer survivors because FCR severity may neither encourage nor hinder most survivors [11]. Cancer survivors with high FCR may experience high levels of distress and may not adhere to healthy lifestyle recommendations [37].…”

“…Stomach cancer is known for being signi cantly in uenced by behavioral and lifestyle risk factors [9]. Smoking, alcohol consumption, chemical exposure, obesity, and dietary factors (such as excessive salt intake) may be associated with the FCR of stomach cancer survivors and was considered a preventable condition [8][9][10][11][12]. Systematic reviews of 43 studies [8] and 130 studies [10] on the factors of FCR revealed that there are no stomach cancer-speci c FCR publications.…”

Can Physical Activity and Healthy Diet Help Long-Term Cancer Survivors Manage Their Fear of Recurrence?

“…The current cross-sectional study is part of a larger longitudinal study examining FCR and health behaviors ( Séguin Leclair et al, 2019 ) using data from the American Cancer Society’s SCS-I, a national prospective longitudinal study of American cancer survivors with data collected in three waves beginning in 2000, T1, M = 1.3 years ( SD = 0.32), T2, M = 2.2 years ( SD = 0.34), and T3, M = 8.8 years ( SD = 0.63) post cancer diagnosis. Participant eligibility criteria were the following: diagnosed with one of the 10 most highly incident cancers [prostate, breast, lung, colorectal, bladder, non-Hodgkin lymphoma (NHL), skin melanoma, kidney, ovarian, and uterine], over 18 years old at diagnosis, residing in one of the target states at the time of diagnosis, and diagnosed with a local, regional, or distant SEER Summary Stage cancer.…”

“…The following socio-demographic and medical variables were examined and controlled for: age at diagnosis, sex, ethnicity, education, cancer site, and cancer stage based on their known relationship with FCR ( Séguin Leclair et al, 2019 ). Relationship status, family income, and occupation were included for sample description purposes only.…”