Prevalence and factors associated with fear of recurrence in a mixed sample of young adults with cancer

Abstract

This study examined the prevalence and factors associated with fear of cancer recurrence (FCR) in young adults (YAs). YAs diagnosed with cancer between the ages of 15 and 39 in Canada (n = 461), who were currently 19years or older, completed the Young Adults with Cancer in their Prime (YACPRIME) Study. The Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) was the primary outcome. Scores ≥ 16 on the FCRI-SF indicate problematic levels and scores ≥ 22 represent clinically significant FCR. Covariates included demographic, clinical cancer variables, and co-morbid symptom measures. Univariate and multivariate logistic regression analyses were performed to identify variables associated with FCR. Participants were predominantly female (87%) with a mean age of 32years (SD = 4.7). Problematic levels of FCR were present in 84% of YAs, and 59% met or exceeded the cutoff for clinically significant FCR. In the multivariate model, time since diagnosis of 5+ years was associated with a reduced likelihood of clinical FCR (Adjusted Odds Ratio [AOR] = 0.354; p = .004), while having a previous recurrence was related to increased likelihood (AOR = 3.468, p = .001). Other factors associated with clinical FCR in YAs were psychological distress (Mild: AOR = 2.947, p = .003; Moderate: AOR = 5.632, p < .0005; Severe: AOR = 8.877, p < .0005), and cancer-related body image dissatisfaction (AOR = 2.311, p = .004). FCR is a pervasive problem for YAs diagnosed with cancer, with previous recurrence and psychological difficulties as factors associated witha higher degree of fear. Psychosocial interventions for YAs targeting depression and anxiety should also prioritize the treatment of FCR.