Prevalence and factors associated with fear of recurrence in a mixed sample of young adults with cancer
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 19 years 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 32 years (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 with a higher degree of fear.
Psychosocial interventions for YAs targeting depression and anxiety should also prioritize the treatment of FCR.
KeywordsYoung adults Fear of cancer recurrence Psychosocial oncology Distress
We gratefully acknowledge the contributions of all the young adults with cancer across Canada who participated in the study.
This study was supported by a patient-oriented research grant from the Newfoundland and Labrador Support for People and Person Oriented Research and Trials (NL SUPPORT) unit. Breanna Lane is funded by a doctoral award from the Translational and Personalized Medicine Initiative/NL SUPPORT Unit. Dr. Sheila Garland is funded by a Beatrice Hunter Cancer Research Institute and Scotiabank New Investigator Award.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Interdisciplinary Committee on Ethics in Human Research (ICEHR) at Memorial University.
All participants provided informed consent as outlined in the digital consent form and were provided with debriefing information upon completion.
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