Objective: Fear of cancer recurrence (FCR) is a significant psychological problem for cancer survivors. Some survivors experience FCR, which is both persistent and highly distressing. The aim of this systematic review was to identify the key factors associated with fear of recurrence among cancer patients.Methods: A comprehensive literature search using keywords was performed with three databases, followed by an organic search to identify additional relevant articles. Included studies had a quantitative methodology presenting empirical findings focussed on adult cancer patients. A methodological quality assessment was performed for each study, and the strength of evidence was defined by the consistency of results.Results: Forty-three studies met the inclusion criteria and are presented in this review. The most consistent predictor of elevated FCR was younger age. There was strong evidence for an association between physical symptoms and fear of cancer recurrence. Additional factors moderately associated with increased FCR included treatment type, low optimism, family stressors and fewer significant others. Inconsistent evidence was found for socio-demographic factors.Conclusions: Fear of cancer recurrence is a complex issue influenced by a multitude of factors, including demographic, clinical and psychological factors. However, some studies have reported contradictory evidence, and FCR has been measured using a range of scales, which can hamper comparison across studies. Further research is needed to clarify inconsistencies in the current published research.
Despite a growing literature on the factors associated with men's low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in men's medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15-80 + ) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals.
Approximately 20 -30% of women delay for 12 weeks or more from self-discovery of a breast symptom to presentation to a health care provider, and such delay intervals are associated with poorer survival. Understanding the factors that influence patient delay is important for the development of an effective, targeted health intervention programme to shorten patient delay. The aim of the study was to elicit knowledge and beliefs about breast cancer among a sample of the general female population, and examine age and socio-economic variations in responses. Participants were randomly selected through the Postal Address File, and data were collected through the Office of National Statistics. Geographically distributed throughout the UK, 996 women participated in a short structured interview to elicit their knowledge of breast cancer risk, breast cancer symptoms, and their perceptions of the management and outcomes associated with breast cancer. Women had limited knowledge of their relative risk of developing breast cancer, of associated risk factors and of the diversity of potential breast cancer-related symptoms. Older women were particularly poor at identifying symptoms of breast cancer, risk factors associated with breast cancer and their personal risk of developing the disease. Poorer knowledge of symptoms and risks among older women may help to explain the strong association between older age and delay in help-seeking. If these findings are confirmed they suggest that any intervention programme should target older women in particular, given that advancing age is a risk factor for both developing breast cancer and for subsequent delayed presentation. British Journal of Cancer (2002) Delayed presentation of symptomatic breast cancer of three months or more is associated with lower survival rates (Richards et al, 1999a). While some of this delay is health-provider related, an estimated 20 -30% of women wait at least three months before seeking medical help for breast symptoms (Richards et al, 1999b). A recent fall in deaths from breast cancer has been reported due to improved survival from a combination of earlier diagnosis, breast screening and improvement in treatment methods (Richards et al, 2000;Peto et al, 2000). The relative contribution of these factors remains to be clarified. In the meantime, breast cancer continues to represent a major public health problem, and further gains in survival might be achieved by encouraging women to seek help more promptly. Understanding the factors that influence patient delay is a prerequisite for the development of strategies to shorten delays. Strong evidence suggests that older women are more likely to delay their presentation with breast cancer, although the strength of evidence for other risk factors for delay is inadequate to inform any intervention (Ramirez et al, 1999). Such factors are likely to relate to women's knowledge and beliefs about breast cancer and its management.The NHS Breast Screening Programme aims to invite all women aged 50 -64 for mammography scree...
SummaryBackgroundHot flushes and night sweats (HFNS) affect 65–85% of women after breast cancer treatment; they are distressing, causing sleep problems and decreased quality of life. Hormone replacement therapy is often either undesirable or contraindicated. Safe, effective non-hormonal treatments are needed. We investigated whether cognitive behavioural therapy (CBT) can help breast cancer survivors to effectively manage HFNS.MethodsIn this randomised controlled trial, we recruited women from breast clinics in London, UK, who had problematic HFNS (minimum ten problematic episodes a week) after breast-cancer treatment. Participants were randomly allocated to receive either usual care or usual care plus group CBT (1:1). Randomisation was done in blocks of 12–20 participants, stratifying by age (younger than 50 years, 50 years or older), and was done with a computer-generated sequence. The trial statistician and researchers collecting outcome measures were masked to group allocation. Group CBT comprised one 90 min session a week for 6 weeks, and included psycho-education, paced breathing, and cognitive and behavioural strategies to manage HFNS. Assessments were done at baseline, 9 weeks, and 26 weeks after randomisation. The primary outcome was the adjusted mean difference in HFNS problem rating (1–10) between CBT and usual care groups at 9 weeks after randomisation. Analysis of the primary endpoint was done by modified intention to treat. The trial is registered, ISRCTN13771934, and was closed March 15, 2011.FindingsBetween May 5, 2009, and Aug 27, 2010, 96 women were randomly allocated to group CBT (n=47) or usual care (n=49). Group CBT significantly reduced HFNS problem rating at 9 weeks after randomisation compared with usual care (mean difference −1·67, 95% CI −2·43 to −0·91; p<0·0001) and improvements were maintained at 26 weeks (mean difference −1·76, −2·54 to −0·99; p<0·0001). We recorded no CBT-related adverse events.InterpretationGroup CBT seems to be a safe and effective treatment for women who have problematic HFNS after breast cancer treatment with additional benefits to mood, sleep, and quality of life. The treatment could be incorporated into breast cancer survivorship programmes and delivered by trained breast cancer nurses.FundingCancer Research UK.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.