Factors associated with fear of cancer recurrence in breast and colorectal cancer survivors: A cross-sectional study of cancer survivors.

Abstract

To define the prevalence and severity of fear of cancer recurrence and identify factors associated with fear of cancer recurrence in breast cancer and colorectal cancer survivors attending the Sydney Cancer Survivorship Clinic. A cross-sectional study was performed using prospectively collected data. Survivors completed questionnaires assessing quality of life (Functional Assessment of Cancer Therapy-General and symptoms (Distress Thermometer, Patient's Disease and Treatment Assessment Form)). Survivors were assessed by a clinical psychologist for the presence of fear of cancer recurrence. Clinical and quality of life variables were evaluated for associations with fear of cancer recurrence. Overall, 315 survivors (181 breast cancer, 134 colorectal cancer) were included. In total, 201 survivors (64%) had fear of cancer recurrence according to psychology assessment, and of the 118 that had fear of cancer recurrence severity recorded, 64 (54%) were rated as moderate-severe. On univariate analysis, fear of cancer recurrence was associated with younger age (P<0.001), higher distress thermometer score (P=0.001) and poorer overall wellbeing (P<0.001). On multivariate analysis, younger age (P=0.043), being bothered by side effects of treatment (P=0.023), feeling sad (P=0.020) and greater worry that their condition will get worse (P=0.017) were independently associated with fear of cancer recurrence. Fear of cancer recurrence is common in breast and colorectal cancer survivors, and moderate-severe in over half. Fear of cancer recurrence was independently associated with younger age, feeling sad, being more bothered by side effects.