Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

CIFeR Advanced - Adapting a clinician led intervention to address fear of cancer progression across advanced malignancies (143636)

Howard Yu 1 2 , Joanne Shaw 3 , Sharon He 3 , Johanne D Lyhne 4 , Allan B Smith 5 6 , Jane Beith 2 7 , Georgia Harris 1 2 , Phyllis Butow 3 , Haryana Dhillon 3 , Jia (Jenny) Liu 8 9 10
  1. Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
  2. Central Clinical School, Sydney Medical School, The Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW, Australia
  3. School of Psychology, The University of Sydney, Camperdown, NSW, Australia
  4. Department of Clinical Oncology, University Hospital of Southern Denmark, Vejle, Southern Denmark, Denmark
  5. The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, NSW, Australia
  6. South West Sydney Clinical Campuses, UNSW Medicine & Health, University of New South Wales, Liverpool, NSW, Australia
  7. Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
  8. The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, NSW, Australia
  9. School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
  10. Garvan Institute of Medical Research, Sydney, NSW, Australia

Aims: Fear of cancer progression (FOP) is a significant unmet need amongst patients with advanced cancer. We previously developed a clinician-delivered intervention to help early-breast cancer patients manage fear of cancer recurrence (FCR) (Clinician Intervention to Reduce Fear of Recurrence (CIFeR)(1),(2). Here we aimed to adapt CIFeR to address FOP in patients with advanced cancer irrespective of tumour type.

Method: Initial multidisciplinary panel representing medical oncology, radiation oncology and psych-oncology reviewed and adapted the original CIFeR intervention to address fear of cancer progression in advanced cancer of any tumour type. This included changes in terminology and the addition of a step addressing scanxiety to the original CIFeR intervention.

Participating clinicians were recruited March to August 2025 through professional organisations. Clinicians completed semi-structured cognitive ‘think-aloud’ interviews via video-conference. Interviews were recorded and transcribed. Data was thematically analysed using a framework approach. Adaptations were systematically mapped using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME), documenting what was modified, why, and at what level (content, format, process, delivery).

Results: Interviews with 20 clinicians (eight medical oncologists/trainees, eight radiation oncologists/trainees, four palliative care physicians) were completed. Interviews identified overall acceptability of the intervention structure. FRAME mapping produced adaptations of CIFeR across the intervention steps, specifically: Normalisation of fear of progression, guidance on prognosis and uncertainty discussion according to patients’ preferences, individualised guidance about symptoms warranting clinical review, provision of strategies to self-manage worry, scanxiety discussion and referral to psycho-oncology. Suggestions around barriers and facilitators for the delivery of intervention were also identified.

Conclusion: CIFeR was systematically adapted to address fear of cancer progression in advanced cancer across tumour types. Feasibility testing with patients is required to assess acceptability and delivery fidelity. Subsequently intervention efficacy should be evaluated.

  1. 1. Liu J, Butow P, Bui KT, Serafimovska A, Costa DSJ, Kiely BE, et al. Novel Clinician-Lead Intervention to Address Fear of Cancer Recurrence in Breast Cancer Survivors. JCO Oncol Pract. 2021;17(6):e774-e84.
  2. 2. Liu J, He S, Butow P, Shaw J, McHardy CJ, Harris G, et al. A novel clinician-delivered intervention to reduce fear of recurrence in breast cancer survivors: Results from a Phase I/II implementation study (CIFeR_2). Psychooncology. 2023;32(12):1930-8.