Fear of cancer recurrence and associations with mental health status and individual characteristics among cancer survivors: Findings from a nationally representative sample.

Abstract

147 Background: Fear of cancer recurrence (FCR) and related constructs are experienced by many cancer survivors and are consistently identified as important areas of need. This study adds to sparse literature on this topic by describing the prevalence of FCR and testing its associations with mental health status measures in a US sample of cancer survivors. Methods: Using the Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (n = 1,032), we examined socio-demographic, health and mental health characteristics of cancer survivors by their level of fear of cancer recurrence (none, low, high). Survey-weighted population-based estimates describe the prevalence of key variables. Multinomial logistic regression was used to test associations between validated measures of mental health status and individual characteristics, and levels of FCR in models unadjusted and controlling for socio-demographic and health characteristics. MEPS survey weights were applied in all analyses to account for the survey design. Results: Overall, 34% of cancer survivors reported no FCR, 54% reported low FCR, and 11% reported high FCR. Cancer survivors were at increased risk of reporting high FCR relative to no FCR if they had a low 12-item Short Form Health Survey (SF-12) Mental Component Summary (MCS) score (≤48) compared to high scores (odds ratio = 2.89; 95% confidence interval (CI) = 1.58, 5.32). Reporting depressive symptoms or psychological distress did not significantly increase the risk of reporting high or low FCR relative to no FCR. Conclusions: This study is the first to provide US population-based estimates of associations between FCR and individual, health and mental characteristics. Our results also provide valuable information on which survivors are most at-risk for FCR, and add to a new and growing literature supporting FCR as a multidimensional construct distinct from depression and distress. Future research is needed to more clearly differentiate FCR from other constructs, specifically anxiety disorders, and to identify clinically significant levels of FCR to better target survivors with the highest needs.