Background:
Fear of cancer recurrence (FCR) is common among cancer survivors (1). We evaluated FCR in the multidisciplinary Sydney Cancer Survivorship Centre (SCSC) clinic.
Methods:
Cancer survivors after primary treatment for early-stage cancer attending SCSC initial clinic were assessed for FCR by a clinical psychologist. Since October 2020, the 7-item FCR-7 questionnaire was added: total score 6-40, scores ≥17 moderate FCR, ≥27 clinically significant FCR. Partially completed FCR-7 was considered missing data.
Baseline characteristics were reported descriptively; chi-square and independent-sample t-tests compared variables. Missing data were handled using pairwise deletion.
Results:
1081 survivors consented; mostly female (68%, n=738), 38% breast; 33% colorectal; 16% haematological; 12% other cancers. Overall, 64% (n=634/985) had psychologist-assessed FCR with 90% (n=569) having FCR severity graded; 55% rated as mild, 32% as moderate, 13% as severe. Proportion assessed by psychologist as having FCR was significantly higher in: survivors <65 years (73% vs 46.5%, p<0.001); females (70% vs 52%, p<0.001), anxiety history (72% vs 63%, p=0.032) but was not associated with disease stage (p=0.241). Survivors with FCR reported higher mean distress scores (mean difference 1.1/10 (95% CI 0.75 – 1.49).
A subset (n=350) completed FCR-7; 68% female; 34% breast; 32% colorectal; 15% haematological; 19% other cancers. Median FCR-7 total score was 16.0 (IQR 11-23); 32% (n=109/344) scored ≥17, 17% (n=60/344) scored ≥27. Among this subset, 235/343 (68.5%) had psychologist-assessed FCR, 59.5% rated as mild (n=138/232), 29% moderate (n=67/232) and 12% severe (n=27). Among survivors scoring ≥17 on FCR-7, 88% were assessed as having FCR by psychologist; with 48% having psychologist-assessed FCR but scoring <17 on FCR-7 (p<0.001).
Conclusion:
It is important to screen for FCR given the frequency of presentation in cancer survivors. The FCR-7 may be used to screen for FCR in clinical settings, but it may miss FCR among those with FCR7 total score <17.