Psychosocial predictors of fear of cancer recurrence in a cohort of gynecologic cancer survivors

• Published in: Psycho-oncology (Chichester, England) Vol. 31; no. 12; pp. 2141 - 2148
• Main Authors: Mell, Carlie A., Jewett, Patricia I., Teoh, Deanna, Vogel, Rachel I., Everson‐Rose, Susan A.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2022; John Wiley and Sons Inc
• Subjects: Anxiety; Anxiety - epidemiology; Anxiety - psychology; Cancer; Cancer Survivors - psychology; Cohort analysis; Cohort Studies; Fear & phobias; Fear - psychology; fear of cancer recurrence; Female; Genital Neoplasms, Female; gynecologic neoplasms; Gynecological cancer; Health psychology; Hopelessness; Humans; Medical diagnosis; Middle Aged; Neoplasm Recurrence, Local - psychology; oncology; Original; Polls & surveys; Post-traumatic growth; posttraumatic growth; Psychological distress; Psychosocial factors; psychosocial oncology; Psychosocial well being; psycho‐oncology; Quality of Life; Recurrence; Survivor; survivors; Survivors - psychology; Women; anxiety; fear of cancer recurrence; survivors; gynecologic neoplasms; posttraumatic growth; psychosocial oncology; cancer; oncology; psycho-oncology
• ISSN: 1057-9249; 1099-1611; 1099-1611
• DOI: 10.1002/pon.6055

Objective To describe fear of cancer recurrence in a cohort of women with gynecologic cancers and to identify psychosocial predictors of elevated fear of recurrence. Methods Survey data from an ongoing cohort study of gynecologic cancer survivors were used (n = 154). Relationships between fear of cancer recurrence measured by the 6‐item Cancer Worry Scale in the most recent survey and psychosocial factors (cancer‐related distress, depression, anxiety, hopelessness, and posttraumatic growth) assessed 6–18 months prior were examined using univariate and multivariate linear regression models, adjusting for age, cancer stage, cancer type, and time since diagnosis. Results Most participants were ≥60 years old, diagnosed with early‐stage cancer, and 2–5 years post‐diagnosis. The mean score on the Cancer Worry Scale was 10.31 (SD = 3.01), and 46 individuals (30.0%) scored ≥12, indicating high fear of recurrence. In univariate analyses, greater distress (p = 0.007), anxiety (p = 0.006), hopelessness (p = 0.007), and posttraumatic growth (p = 0.0006) were significantly associated with higher scores on the Cancer Worry Scale. The associations of hopelessness and posttraumatic growth with higher Cancer Worry Scale scores remained significant after adjustment for covariates. Conclusions Fear of recurrence is frequent among gynecologic cancer survivors. Women who reported more distress, hopelessness, anxiety and, surprisingly, more post‐traumatic growth reported more fear. These results contribute to our understanding of which cancer survivors are most at risk of elevated fear of recurrence and highlight the importance of continued focus on psychosocial well‐being among cancer survivors.