Fear of recurrence among cancer survivors.

Abstract

10053 Background: Fear of cancer recurrence (FoCR) following definitive cancer therapy is often reported by patients, but little is known about who is most likely to be impacted, how FoCR influences emotional distress, and what interventions may mitigate patients’ FoCR. We sought to determine the prevalence of FoCR among cancer survivors and to evaluate potential predictors of FoCR in this population. Methods: As part of a comprehensive supportive care needs assessment, we evaluated the prevalence of FoCR among patients receiving follow-up cancer care at our institution as well as factors associated with FoCR. Elevated FoCR was measured with a single item: “I worry about my cancer coming back” rated on a 4-point Likert scale (1 = “not at all” to 4 = ”very much”); responses of 3 or 4 were considered positive for FoCR. Descriptive statistics were used to characterize patterns of FoCR. Chi-square and Fisher’s exact tests compared differences in emotional, clinical, and demographic characteristics between participants with and without FoCR, as well as interest in and knowledge of survivorship services. Results: Of 636 patients who completed the survey, 318/636 (50.0%) patients had curable cancer and had either completed cancer therapy or were completing maintenance treatment. On inquiry, 167/318 (53%) reported FoCR. Those with FoCR were more likely to be female (p < 0.002) and under the age of 70 (p < 0.003). They were also more likely to be sad (25% vs. 14%, p < 0.015), anxious (40% vs. 21% p < 0.0005), feel uncertain about the future (30% vs. 14%, p < 0.0005), have problems managing stress (26% vs. 13%, p < 0.003), and were more likely to worry about dying (55% vs. 8%, p < 0.0001) and to fear another cancer (74% vs. 8% p < 0.0001). Education level, cancer type, knowledge of and interest in support services, and survivorship care plan receipt were not associated with FoCR. Conclusions: Patient FoCR is prevalent among more than half of survivors of cancer and is associated with emotional distress that is insufficiently addressed by survivor care planning and supportive services. Clinicians can and should screen for and address this issue. Future research is needed to develop and test interventions, beyond care plans, to address FoCR in both low risk and high risk patient populations.