Pan-cancer analysis of fear of cancer recurrence in cancer survivors.

Abstract

e24104 Background: Fear of cancer recurrence (FCR) in cancer survivors is an understudied phenomenon estimated to one-third to over half of all cancer survivors. FCR has been shown to contribute to treatment noncompliance and portend a decrease in overall survival (OS). The purpose of this study was to examine factors associated with needs related to FCR among patients seen at a solid tumor survivorship clinic at a National Cancer Institute designated center. Methods: Data collected as part of a patients’ needs assessment that is administered to patients (n = 657) with solid tumors such as breast, genitourinary, gastrointestinal malignancies at their initial clinic visit were analyzed. Correlations between responses were calculated and univariable and multivariable logistic regression was used to identify predictors of met or unmet needs related to FCR. Results: There were a total of 657 patients included 442 (67.3%) female and 215 (32.7%) male. The majority of patients (84.5%) were white (n = 555), followed by 9.74% black (n = 64), the remaining patients identified as ‘other’ or Asian. The patients median age was 67 years, median age of diagnosis 55 years, and median years since diagnosis 10 years. 613 patients had recorded distress scores ranging from 0 (n = 214), 1-4 (n = 255), 5-7 (n = 106), or 8-10 (n = 38). Of 647 patients, 241 (37.2%) reported FCR was not a need and 386 (59.7%) reported FCR was a met need. According to univariate logistic regression gender had no impact on FCR (p = 0.8427) nor did years since diagnosis (p = 0.1014). Results of multivariable regression indicate the odds ratio of reporting FCR as an unmet need (vs not a need) decreases by 6% (p = 0.0023) for every year increase in age. For each unit increase in distress score the odds ratio of reporting FCR as an unmet need is increased by 32% (p = 0.0007). Conclusions: Our data suggests that patients reporting higher distress scores are more likely to report FCR as an unmet need. Therefore, survivors with high distress scores reported in clinic visits should be evaluated for FCR. FCR reported as an unmet in our study is significantly less. Further stratification of FCR can be helpful for providers caring for survivors to identify and address FCR more effectively in clinical care. Further study is needed to learn how survivors have come to identify the need as being met.