Does fear of cancer recurrence predict cancer survivors' health care use?
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Fear of cancer recurrence (FCR) is the most frequently cited unmet need among cancer survivors. Theoretical models of FCR suggest that patients with elevated levels of FCR will more frequently consult health care professionals for reassurance about their health. However, the relationship between FCR and health care utilization has not yet been firmly established. We examined the relationship between FCR and quantity of medications, number of emergency room (ER) visits, outpatient visits, specialist visits, allied health visits, and hospital overnight visits.
A total of 231 participants diagnosed with breast, colon, prostate, or lung cancer in the past 10 years were recruited from a cancer survivor registry. Participants were sent a survey package that included demographic and medical characteristics, a health care utilization questionnaire, and the Fear of Cancer Recurrence Inventory.
A multiple regression analysis indicated that higher FCR significantly predicted greater number of outpatient visits in the past 6 months (ß = .016, F(1, 193) = 5.08, p = .025). A hierarchical multiple regression indicated that higher FCR significantly predicted greater number of ER visits in the past 6 months when controlling for relationship status and education level (F(1, 179) = 4.00, p = .047).
The relationship between FCR and health care use has been understudied. Results indicate that patients with elevated FCR may indeed use more health care services. We recommend that clinicians monitor health care use in patients who are struggling with FCR.
KeywordsFear of cancer recurrence Cancer survivors Health care use
This research was supported through a Research Development Grant from the University of Ottawa to Sophie Lebel. We appreciate the efforts of our volunteers on this project: Lynne Potvin, Megan Fillier, Brigitte Corran, Stephanie Robert, Rosa Leblanc, and Kristin Loeper. We extend our gratitude to the staff at Cancer Care Ontario for their invaluable help with recruitment.
Conflict of interest
The authors do not have a financial relationship with any of the organizations that sponsored the research.
- 10.Maszczakiewicz E, Jolicoeur L, Lebel S, Lefevbre M (2009) Fear of recurrence and its effects on patient satisfaction with follow-up after primary therapy for endometrial cancer. Annual Meeting of the Canadian Association of Psychosocial Oncology, Vancouver, Canada, April 1–4, 2009Google Scholar
- 12.Thewes B, Butow P, Bell ML, Beith J, Stuart-Harris R, Grossi M, Capp A, Dalley D, the FCR Study Advisory Committee (2011) Fear of cancer recurrence in young women with a history of early-stage breast cancer: a cross-sectional study of prevalence and association with health behaviours. Support Care Cancer. doi: 10.1007/s00520-011-1371-x
- 14.Simard S, Savard J (2008) Screening and psychiatric comorbidity of clinical fear of cancer recurrence. Paper presented at the 4th Canadian Breast Cancer Research Alliance Reasons for Hope Scientific Conference, Vancouver, CanadaGoogle Scholar
- 15.Schultz KR (2011). A Randomized Multicentre Study Comparing G-CSF Mobilized Peripheral Blood and G-CSF Stimulated Bone Marrow in Patients Undergoing Matched Sibling Transplantation for Hematologic Malignancies [Grant 5R01CA108752-05 proposal to the National Institutes of Health (NIH)]Google Scholar
- 16.Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA (2000) Gender differences in the utilization of health care services. J Fam Prac 49(2):147–152Google Scholar
- 19.Rosen NO, Knauper B, Di Dio P, Morrison E, Tabing R, Feldstain A, Amsel R, Mayrand MH, Franco EL, Rosberger Z (2010) The impact of an intolerance of uncertainty on anxiety after receiving an informational intervention about HPV: a randomized controlled study. Psychol Health 25(6):651–668PubMedCrossRefGoogle Scholar
- 20.Heins MJ, Korevaar JC, Rijken PM, Schellevis FG (2012) For which health problems do cancer survivors visit their general practitioner? Eur J Cancer. doi: 10.1016/j.ejca.2012.07.011 [Epub ahead of print]