Fear of cancer recurrence among young adult cancer survivors\u2014exploring long-term contributing factors in a large, population-based cohort

Kathrine F Vandraas,Hanne C Lie,Cecilie E Kiserud,Kristin V Reinertsen

doi:10.1007/s11764-020-00943-2

Kathrine F Vandraas, Hanne C Lie + Show 2 more

Open Access

https://doi.org/10.1007/s11764-020-00943-2

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Abstract

PurposeFear of cancer recurrence (FCR) may be debilitating, yet knowledge of FCR among the growing population of long-term young adult cancer survivors (YACS) is scarce. We explored risk of FCR and associated factors in a nation-wide, population-based cohort of YACS.MethodsAll 5-year survivors diagnosed at the ages of 19–39 years with breast cancer (BC), malignant melanoma (MM), colorectal cancer (CRC), leukemia (LEU), or non-Hodgkin lymphoma (NHL) between 1985 and 2009 in Norway were identified by the Cancer Registry of Norway and completed the cross-sectional comprehensive NOR-CAYACS health survey. Univariate and multivariate linear regression modeling was performed.ResultsIn total, 936 survivors were included, with an average of 16 years since diagnoses. BC was the most prevalent cancer form (38.4%), followed by MM (24.7%), NHL (15.6%), CRC (11.8%), and LEU (9.6%). Survivors worried most about getting another cancer (74%), and (20%) 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 (Std B 0.21, p < 0.01), above demographic and clinical variables.ConclusionsFCR is prevalent even among long-term YACS, including survivors of MM with favorable prognoses.Implications for Cancer SurvivorsAttention to ongoing risks of PTSS and FCR in this growing survivor population is warranted to optimize future survivorship care.

Highlights

Due to advances in diagnostics and treatment, more than 80% of young adult (YA) patients diagnosed with cancer will become long-term survivors [1]
This is a sub-study of the NOR-CAYACS study [24], a crosssectional, population-based questionnaire study including all 5-year survivors of childhood, adolescent, and selected diagnostic groups of young adult cancers in Norway identified through the Norwegian Cancer Registry (CRN)
The NORCAYACS study consists of 3558 young adults diagnosed at the ages of 19 to 39 years, with breast cancer (BC), colon-rectal cancer (CRC), non-Hodgkin lymphoma (NHL), leukemia (LEU), or malignant melanoma (MM) between 1985 and 2009

Summary

Introduction

Due to advances in diagnostics and treatment, more than 80% of young adult (YA) patients diagnosed with cancer will become long-term survivors [1]. Research on the YA cancer group is only recently gaining momentum but suggests that survivors have a high risk of late effects [2] negatively affecting their quality of life [3], and reduced life expectancy, Young adulthood, defined as the age period from 19 to 39 years [10], is a critical transitional phase where attainment of life-milestones, such as completion of education and. PTSS has predominately been demonstrated in studies of adult survivors of childhood cancer [13]. Knowledge of PTSS among YA cancer survivors is limited, but prevalence rates of 39–50% have been reported in early phases of survivorship (< 24 months post-diagnosis) [14]. The prevalence was stable at 12 months, and diagnoses with a high curation rate (90–100%) were positively associated with PTSS [15], suggesting that PTSS may persist over time, and develop irrespective of prognosis

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