Utilization of health care services in cancer patients with elevated fear of cancer recurrence

Champagne, Alexandra; Ivers, Hans; Savard, Josée

doi:10.1002/pon.4748

Cited by 45 publications

(81 citation statements)

References 29 publications

(101 reference statements)

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“…In survivors of adult cancer, maladaptive health behaviors (e.g., repeated medical visits for reassurance-seeking) are correlated with and considered as adverse outcomes of FCR. 4 Parents likely instigate these medical visits for their child, and thus the child's healthcare utilization will likely be moderated through their parents' FCR.…”

Section: Parent/child Relationshipmentioning

confidence: 99%

Fear of cancer recurrence in childhood cancer survivors: A developmental perspective from infancy to young adulthood

Tutelman

Heathcote

2020

Psycho-Oncology

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Aims: Fear of cancer recurrence (FCR) is among the most prevalent and distressing concerns reported by cancer survivors. While younger age is the most consistent predictor of elevated FCR, research to date has focused almost exclusively on adult cancer survivors. This is despite the fact that children with cancer are more likely to survive compared to adults, and will become regular, lifelong users of the medical system to mitigate the effects of toxic treatment. The early experience of cancer yields unique challenges and circumstances that may impact children's capacity for and experience of FCR across the developmental trajectory. The aim of this paper is to present a developmental perspective of FCR from infancy to young adulthood. Methods: Drawing on the developmental science literature and recent theoretical advancements in FCR, we outline cognitive and social factors that may influence children's capacity for and experience of FCR across the developmental trajectory. Results: First, distinct developmental groups that fall under the classification of "childhood cancer survivor," and that all require attention, are summarized. Using the structure of these groupings, we centrally provide a developmental perspective of FCR that offers a useful starting point for research in pediatric populations. Key research gaps, including the need for validated assessment tools to measure FCR in child and adolescent survivors, are highlighted. Conclusions: Consideration of the unique context of childhood is needed to guide the identification of childhood cancer survivors at risk for FCR as well as the development of effective FCR interventions for this population.

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Section: Parent/child Relationshipmentioning

confidence: 99%

Fear of cancer recurrence in childhood cancer survivors: A developmental perspective from infancy to young adulthood

Tutelman

Heathcote

2020

Psycho-Oncology

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“…In addition, from a public health standpoint, FCR is related to increased health-care utilization and costs (15, 16). In a recently published study, FCR was the most distressful and commonly reported problem by patients with breast cancer (17, 18).…”

Section: Introductionmentioning

confidence: 99%

Psychometric Properties of the Short Form of the Fear of Cancer Recurrence Inventory (FCRI) in Chinese Breast Cancer Survivors

Huang

Zhang

et al. 2019

Front. Psychiatry

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Objective: Currently, fear of cancer recurrence (FCR) is emerging as an important issue for long-term breast cancer survivors and is associated with lower quality of life and functional impairment. Given that there is a dearth of research regarding the FCR of Chinese breast cancer survivors, this study investigated whether the short form of the Fear of Cancer Recurrence Inventory (FCRI) could detect high FCR and explored the level and characteristics of FCR in breast cancer survivors. Methods: Two hundred forty patients who had undergone successful breast cancer surgery in China submitted their survey through a website. The participants’ demographic and medical data, level of FCR, anxiety, depression, and quality of life were assessed. Results: Two hundred seven patients with ages ranging from 19 to 60 years completed the questionnaires. The mean FCR score of the total sample was 18.39. A cutoff score of 12 or higher on the short form of the FCRI was optimal for the detection of high FCR with a sensitivity of 98.6% and a specificity of 35%, and the PPV (positive predictive values) and NPV (negative predictive values) were 44% and 98%, respectively. The area under the curve of the receiver operating characteristics (ROC) analysis was 83%. A total of 159 breast cancer survivors (76.81%) experienced high FCR levels (FCR score > 12), characterized by lower functional and overall health than survivors with a low FCR ( P < 0.01). Conclusions: The short form of the FCRI is capable of detecting high FCR and is therefore able to assist Chinese breast cancer survivors in receiving appropriate care for reducing FCR.

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“…[3][4][5] At the system level, clinical FCR is associated with increased health-care costs. [6][7][8] Research on FCR is growing rapidly, with increasing data on its prevalence, correlates and treatment across cancer types. 2,9 Efforts to systematically capture FCR have been hampered by a lack of agreement regarding a gold standard measure and use of miscellaneous assessment tools of variable quality.…”

Section: Introductionmentioning

confidence: 99%

Spotlight on the Fear of Cancer Recurrence Inventory (FCRI)

Smith¹,

Costa²,

Galica³

et al. 2020

PRBM

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Fear of cancer recurrence (FCR) is a pervasive concern for people living with cancer. The rapidly expanding FCR literature has been weakened somewhat by use of miscellaneous FCR measures of varying quality. The Fear of Cancer Recurrence Inventory (FCRI) has been widely used in observational and intervention studies and the FCRI severity subscale, also known as the FCRI-Short Form (FCRI-SF), is often used to identify potential cases of clinically significant FCR. Given the FCRI’s increasing use in research and clinical practice, we aimed to provide an overview, critique, and suggested improvements of the FCRI. Studies citing the original FCRI validation paper were identified and synthesised using narrative and meta-analytic methods. The 42-item FCRI has demonstrated a reasonably robust 7-factor structure across evaluations in multiple languages, although certain subscales (eg, Coping) demonstrate sub-optimal reliability. Confirmation of the cross-cultural equivalence of several FCRI translations is needed. Meta-analysis of FCRI-SF scores revealed a combined weighted mean score of 15.7/36, a little above the lowest proposed cut-off score (≥13) for clinical FCR. Depending on the FCRI-SF cut-off used, between 30.0% and 53.9% of the cancer population (ie, patients and survivors) appear to experience sub-clinical or clinical FCR. Higher FCRI scores were associated with younger age and female gender, pain/physical symptoms and psychological morbidity, consistent with the FCR literature generally. Issues regarding the application and interpretation of the FCRI remain. Whether the FCRI is well suited to assessing fear of progression as well as recurrence is unclear, the meaningfulness of the FCRI total score is debatable, and the use of the FCRI-SF to screen for clinical FCR is problematic, as items do not reflect established characteristics of clinical FCR. Refinement of the FCRI is needed for it to remain a key FCR assessment tool in future research and clinical practice.

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Utilization of health care services in cancer patients with elevated fear of cancer recurrence

Abstract: Cancer patients with clinical levels of FCR are more likely to consult health care providers and to use psychotropic medications, which may translate into significant costs for society and the patients themselves.

Cited by 45 publications

References 29 publications

Fear of cancer recurrence in childhood cancer survivors: A developmental perspective from infancy to young adulthood

Fear of cancer recurrence in childhood cancer survivors: A developmental perspective from infancy to young adulthood

Psychometric Properties of the Short Form of the Fear of Cancer Recurrence Inventory (FCRI) in Chinese Breast Cancer Survivors

Spotlight on the Fear of Cancer Recurrence Inventory (FCRI)

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