Predictors and patterns of fear of cancer recurrence in breast cancer survivors.

McGinty, Heather L.; Small, Brent J.; Laronga, Christine; Jacobsen, Paul B.

doi:10.1037/hea0000238

Cited by 101 publications

(124 citation statements)

References 47 publications

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“…Handling fear of cancer recurrence or progression is one of the most prominent [9] and common, with moderate to high levels present in 30–70% of cancer survivors [10, 11]. Concerns about additional cancer diagnoses, recurrence, progressions, or death are likely to persist throughout survivorship, as former patients will continue to encounter cancer-related triggers (e.g., follow-up appointments, public health campaigns, new diagnoses in family or friends) after treatment ends [12, 13, 34]. In line with these findings, survivors in the present study on average endorsed moderate to high levels of fear of recurrence or progression.…”

Section: Discussionsupporting

confidence: 88%

“…Chief among these is fear of recurrence or progression [9], with moderate to high levels present in 30–70% of cancer survivors [10, 11]. Fear of recurrence or progression can be triggered by cancer-related stimuli throughout survivorship, such as follow-up appointments [12, 13]. Survivors’ worries about disease recurrence or progression may continue for years after treatment ends [12, 14, 15] and can persist at levels equal to that experienced at the time of diagnosis [16].…”

Section: Introductionmentioning

confidence: 99%

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Fear of recurrence or progression as a link between somatic symptoms and perceived stress among cancer survivors

Hall

Lennes

Pirl

et al. 2016

Support Care Cancer

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Purpose Many cancer survivors report experiencing somatic symptoms as well as elevated stress. Theoretical models have suggested that physical symptoms generate subjective stress via fears of recurrence or progression. To date, this indirect effect has not been established empirically. This study aimed to provide preliminary evidence as to whether fear of recurrence or progression is an intermediary between somatic symptom severity and perceived stress among heterogeneous cancer survivors. Methods Adult cancer survivors (N = 67; median 2.4 years since diagnosis; 34% male) presenting at a hospital survivorship clinic completed measures assessing somatic symptom severity (Patient Health Questionnaire-15 (PHQ-15)), perceived stress (four-item Perceived Stress Scale (PSS-4)), and fear of recurrence or progression (Assessment of Survivor Concerns (ASC)). Interrelatedness among variables was assessed using Pearson correlations. Indirect effects were modeled using 5000-iteration bootstrapping. Results Survivors endorsed a range of somatic symptom severity (29% minimal, 39% low, 18% medium, and 14% high). Somatic symptoms, perceived stress, and fear of recurrence or progression were all significantly positively correlated (rs 0.29 to 0.47). Controlling for time since diagnosis, there was a significant indirect effect of somatic symptom severity on stress via fear of recurrence or progression [B = 0.06, SE = 0.04 (95% CI 0.01–0.16)]. The model accounted for more than one third of the variance in perceived stress [R2 = 0.35, F(3,54) = 9.59, p < 0.001]. Conclusions Survivors with greater somatic symptoms tended to report higher levels of stress, due in part to elevated fears of recurrence or progression. Our findings support concerns about recurrence or progression as a mechanism underlying stress states in cancer survivors. Efforts to assist survivors with stress management should teach strategies for managing cancer-related uncertainties stemming from somatic symptoms.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Fear of recurrence or progression as a link between somatic symptoms and perceived stress among cancer survivors

Hall

Lennes

Pirl

et al. 2016

Support Care Cancer

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“…In breast cancer survivors who were getting their mammograms, women who reported greater perceived risk, lower coping self-efficacy and greater reassurance-seeking behaviors were more likely to be in the higher FOR group. 50 Unsurprisingly, FOR tends to increase around the time of scans or other testing for recurrence. 51 FOR may be important to address as it has been related with negative health behaviors such as smoking and lower levels of physical activity.…”

Section: Anxiety and Depression In Different Populations Of Survivorsmentioning

confidence: 99%

Anxiety and Depression in Cancer Survivors

Syrjala

2017

Medical Clinics of North America

254

146

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Synopsis Most cancer survivors adjust well to life after cancer but some experience persisting negative mood such as cancer-related fears, post-traumatic stress, anxiety, or depression. Mood fluctuations may not reach criteria for a clinical diagnosis but sub-clinical symptoms can interfere with quality of life. Females, and adolescents and young adults are particularly at risk for mood disturbances. Behavioral interventions such as cognitive behavioral therapy and pharmacological treatments can effectively treat these distressing emotions. Much of the research on managing emotional needs after cancer has been completed with breast cancer survivors and more work is needed with diverse groups of survivors.

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“…In recently published studies, a variety of factors were found to be associated with the cancer patients’ FCR level. Demographic characteristics such as female gender, young age, living apart or divorce, a higher level of education, and no children have been reported to be related to higher FCR.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing fear of cancer recurrence in patients with breast cancer: Evidence from a survey in Yancheng, China

Niu

Liang

Niu

2019

J of Obstet and Gynaecol

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Aim To identify the characteristics of fear of cancer recurrence (FCR) in breast cancer patients after surgery and investigate the relationship of FCR with demographic and medical characteristics, quality of life (QOL) and social support. Methods The short version of the Fear of Progression Questionnaire (FoP‐Q‐SF), the functional assessment of cancer therapy for breast cancer (FACT‐B) and the Social Support Rating Scale were administered to the 342 breast cancer patients who had undergone surgical treatment. The analysis was performed to determine potential predictors associated with FCR. Results Of the 465 patients, 342 (73.5%) agreed to take part in the study. The mean age of participants was 51.46 ± 10.50 years (range, 30–81). Of the 342 participants, 92 (26.9%) cases were at Stage I, 131 (38.3%) cases at Stage II, 34 (9.9%) patients at Stage III and 85 (24.9%) patients at Stage IV. Among the 12 items of the FoP‐Q‐SF, the three greatest fears were: Item 10 ‘Worrying that medications could damage the body’, Item 1 ‘Being afraid of disease progression’ and Item 2 ‘Being nervous prior to doctors’ appointments or periodic examinations’. About 68.4% of patients reported the dysfunctional level of fear of progression. Multiple linear regression analysis showed that religious belief, family income, disease stages, social support, QOL were identified as independent predictors for FCR. Conclusion We found that FCR is prevalent in postoperative breast cancer patients, and is influenced by many factors. It is necessary to implement positive intervention measures to alleviate the FCR and improve the QOL of patients.

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Predictors and patterns of fear of cancer recurrence in breast cancer survivors.

Abstract: These study findings support the use of the CBM in predicting which cancer survivors experience greater FCR and indicates that CBM-driven interventions may prove beneficial for reducing distressing FCR.

Cited by 101 publications

References 47 publications

Fear of recurrence or progression as a link between somatic symptoms and perceived stress among cancer survivors

Fear of recurrence or progression as a link between somatic symptoms and perceived stress among cancer survivors

Anxiety and Depression in Cancer Survivors

Factors influencing fear of cancer recurrence in patients with breast cancer: Evidence from a survey in Yancheng, China

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