Abstract

Fear of cancer recurrence (FCR) may be debilitating, yet knowledge of FCR among the growing population of long-term young adult survivors (YACS) is scarce. We explored risk of FCR and associated factors in a nation-wide, population-based cohort of YACS. All 5-year survivors diagnosed at the ages of 19-39 years with breast cancer (BC), malignant melanoma (MM), colorectal cancer (CRC), acute lymphatic leukemia (ALL) and non-Hodgkin lymphoma (NHL) during 1985-2009 in Norway, were identified by the Cancer Registry of Norway (CRN) and completed the cross-sectional comprehensive NOR-CAYACS health survey. Group comparisons were performed using ANOVA. Univariate and multivariate linear regression modelling was performed. In total, 936 YACs were included in the study, with an average of 16 years since diagnoses. Survivors worried most about getting another cancer (74%). One in five reported quite a bit or a lot of FCR. BC and MM survivors had the highest FCR scores. Post-traumatic stress symptoms (PTSS) had the strongest association with FCR, over and above demographic and clinical variables. This is the first study to demonstrate that FCR is prevalent among YACs even decades beyond treatment completion, including survivors of MM with favorable prognoses. Attention to ongoing risks of PTSS and FCR in this growing survivor population is warranted to optimize future survivorship care.

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