Factors Correlated With Fear of Cancer Recurrence in Cancer Survivors: A Meta-analysis.

Abstract

Fear of cancer recurrence (FCR) is one of the most common and aversive psychological phenomena among cancer survivors. Understanding the independent and potentially modifiable risk factors that contribute toward FCR seen in cancer survivors would inform future interventional trials aimed at reducing this risk. The aim of this study was to provide an evidence synthesis of factors correlated with FCR to inform the development of preventive interventions. A literature search was performed of the PsycINFO, EMBASE, and MEDLINE (PubMed) databases. Reports published from inception to 2020 focusing on the correlates of FCR with physical, psychological, and social factors were identified. Authors assessed the studies' risk of bias in accordance with the Standard Quality Assessment Criteria for Quantitative Studies (QualSyst criteria) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using RevMan 5.3 software. Thirty-four articles were included in this study with a total sample of more than 13 000 cancer patients. Fear of cancer recurrence was positively correlated with anxiety, depression, avoidance, chemotherapy, distress, intrusive thoughts, fatigue, rumination, and neuroticism. It was negatively correlated with optimism, age, social support, quality of life, time since diagnosis, well-being, and self-efficacy. We identified 16 factors that are correlated with FCR, 9 positively correlated with FCR and 7 negatively correlated with FCR. The findings of this study provide direction for the development of precise interventions for FCR in cancer survivors and lay the foundation for the further construction of an FCR-related nursing theoretical framework.