The role of interpretation biases and symptom burden in fear of cancer recurrence/progression among ovarian cancer survivors

Abstract

Background Models of fear of cancer recurrence or progression (FCR/P) suggest that the way in which people interpret ambiguous physical symptoms is an important contributor to the development and maintenance of FCR/P, but research has not investigated this claim. The aim of this study is to fill that gap. Methods This was a cross‐sectional study. Sixty‐two women with ovarian cancer reported completed measures of FCR/P, an interpretation bias task and a symptom checklist. The healthy control group (n = 96) completed the interpretation bias task. Results Women with ovarian cancer were more likely to interpret ambiguous words as health‐related compared to healthy women (p < 0.001; Cohen's d = 1.28). In women with cancer, FCR/P was associated with overall symptom burden (r = 0.25; p = 0.04) and interpretation bias score (r = 0.41; p = 0.001), but interpretation bias and symptom burden were not related (r = 0.22; p = 0.09). Interpretation bias did not moderate the relationship between symptoms and FCR/P. Conclusions We found that women with ovarian cancer interpreted ambiguous words as health related more often compared to women without cancer, and this bias was greater for women with higher FCR/P. Symptom burden was also associated with FCR/P. However, interpretation bias did not moderate the relationship between physical symptoms and FCR/P. Hence, the central tenet of the Cancer Threat Interpretation model was not supported in women with ovarian cancer.

Does interpretation bias moderate the relationship between pain and fear of cancer recurrence?

“…Among those with the lowest levels of interpretation bias, pain and FCR were not significantly related. These results were predicted, but not consistent with our earlier study with ovarian cancer survivors where we failed to find the predicted moderation effect (Pradhan, Sharpe, Butow, & Russell, 2021). There are a number of possible reasons why the model might have been better supported in a breast cancer sample than an ovarian cancer sample.…”

“…The responses were then categorized into threat/health-related (1) (e.g., injection) or neutral (0) (e.g., sewing). This task has previously been used in relation to cancer and FCR/P (Pradhan, Sharpe, Butow, & Russell, 2021).…”

“…However, interpretation biases did not moderate the relationship between symptoms and FCR/P, as the Cancer Threat Interpretation model predicted (Pradhan, Sharpe, Butow, & Russell, 2021). Pradhan, Sharpe, Butow, and Russell (2021) suggested that there were several reasons for this. First, ovarian cancer has high rates of recurrence and many women in their sample had active disease.…”

“…The aim of this study is to extend the research of Pradhan, Sharpe, Butow, and Russell (2021) by: (a) replicating the methods in a group of women with breast cancer rather than ovarian cancer; (b) including a larger sample; (c) including measures of both FCR and FOP; and (d) including other known predictors, such as metacognitions, intrusive thoughts and threat expectancy to determine whether interpretation biases contribute to FCR/P over and above other known predictors.…”

Interpretation Bias in Breast Cancer Survivors Experiencing Fear of Cancer Recurrence

“…The current study examined whether interpretation bias is associated with FCR, as prior research has suggested ( Lee-Jones et al, 1997 ; Lichtenthal et al, 2017 ; Pradhan et al, 2021 ). We also examined somatic, demographic and medical correlates of cancer-related interpretation bias.…”