Abstract
Objective: Currently, fear of cancer recurrence (FCR) is emerging as an important issue for long-term breast cancer survivors and is associated with lower quality of life and functional impairment. Given that there is a dearth of research regarding the FCR of Chinese breast cancer survivors, this study investigated whether the short form of the Fear of Cancer Recurrence Inventory (FCRI) could detect high FCR and explored the level and characteristics of FCR in breast cancer survivors. Methods: Two hundred forty patients who had undergone successful breast cancer surgery in China submitted their survey through a website. The participants’ demographic and medical data, level of FCR, anxiety, depression, and quality of life were assessed. Results: Two hundred seven patients with ages ranging from 19 to 60 years completed the questionnaires. The mean FCR score of the total sample was 18.39. A cutoff score of 12 or higher on the short form of the FCRI was optimal for the detection of high FCR with a sensitivity of 98.6% and a specificity of 35%, and the PPV (positive predictive values) and NPV (negative predictive values) were 44% and 98%, respectively. The area under the curve of the receiver operating characteristics (ROC) analysis was 83%. A total of 159 breast cancer survivors (76.81%) experienced high FCR levels (FCR score > 12), characterized by lower functional and overall health than survivors with a low FCR (P < 0.01). Conclusions: The short form of the FCRI is capable of detecting high FCR and is therefore able to assist Chinese breast cancer survivors in receiving appropriate care for reducing FCR.
Highlights
Breast cancer is the most common cancer among women worldwide [1]
Our results demonstrated that a cutoff score of 12 or higher on the short form of the FCRI had optimal sensitivity and specificity values for screening clinical fear of cancer recurrence (FCR)
Simard and Savard found that the short form of FCRI was a rapid and effective tool to screen clinical levels of FCR, and a cutoff score of 13 or higher on the FCRI-SF was found in 60 French-Canadian mixed cancer survivors [21]
Summary
In China, breast cancer has been the leading cause of cancer incidence in women [2]. With more attention paid to the life-after-treatment phase, many breast cancer survivors experience multiple physical and psychosocial long-term and delayed effects of treatment (e.g., fatigue, pain, and anxiety) [6,7,8]. Emerging evidence has demonstrated that fear of cancer recurrence (FCR) is a problematic long-term and delayed effect experienced by cancer survivors. Cancer survivors report an unmet need for help dealing with FCR. Previous researchers report prevalence rates of FCR ranging from 37% to 99% among breast cancer survivors [10,11,12]. It was found that cancer survivors with high FCR often experience more selffocus and excessive psychological distress [14]. In a recently published study, FCR was the most distressful and commonly reported problem by patients with breast cancer [17, 18]
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