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

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Abstract

Purpose

This study examined the prevalence and factors associated with fear of cancer recurrence (FCR) in young adults (YAs).

Methods

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.

Results

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).

Conclusions

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.

Implications

Psychosocial interventions for YAs targeting depression and anxiety should also prioritize the treatment of FCR.

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Acknowledgements

We gratefully acknowledge the contributions of all the young adults with cancer across Canada who participated in the study.

Funding

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.

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Authors and Affiliations

  1. Department of Psychology, Faculty of Science, Memorial University of Newfoundland, 232 Elizabeth Avenue, St. John’s, NL, A1B 3X9, Canada

    Breanna E. Lane & Sheila N. Garland

  2. Discipline of Oncology, Faculty of Medicine, Memorial University, St. John’s, NL, Canada

    Sheila N. Garland

  3. Young Adult Cancer Canada, St. John’s, NL, Canada

    Karine Chalifour & Geoff Eaton

  4. School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada

    Sophie Lebel

  5. School of Nursing, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada

    Jacqueline Galica

  6. Ingram School of Nursing, McGill University, Montreal, QC, Canada

    Christine Maheu

  7. Département des sciences de la santé, Université du Québec à Chicoutimi (UQAC) QC, Chicoutimi, Canada

    Sébastien Simard

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  1. Breanna E. Lane
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  5. Sophie Lebel
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Correspondence to Sheila N. Garland.

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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.

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Lane, B.E., Garland, S.N., Chalifour, K. et al. Prevalence and factors associated with fear of recurrence in a mixed sample of young adults with cancer. J Cancer Surviv 13, 842–851 (2019). https://doi.org/10.1007/s11764-019-00802-9

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