The impact of Fear of Cancer Recurrence on wellness (#82)
In 2011, a review of the Clinical practice guidelines for the psychosocial care of adults with cancer (2003) identified Fear of Cancer Recurrence (FCR) as a priority topic to further strengthen evidence-based psychosocial care for people with cancer. A systematic review was undertaken in 2012 to examine 1) the prevalence of FCR in cancer patients/survivors 2) the factors associated with FCR 3) the impact of FCR on patient wellness and 4) effective interventions for reducing FCR.
An expert multidisciplinary working group, including consumers and health professionals, was established to oversee the development of the clinical practice guideline. The guideline was based on a systematic review of the evidence addressing the above four research areas. The review involved a quality assessment of all included studies, using the QualSyst quantitative checklist.
The systematic review included 139 relevant peer-reviewed studies for review. The evidence from the review indicated that FCR is experienced by the majority of cancer survivors and is consistently self-reported as a major area of unmet need. Younger age, lower educational status, lower income, and the presence of treatment side effects were associated with higher FCR, as were higher levels of distress, depression, anxiety, cancer-specific distress and post-traumatic stress disorder symptoms.
Higher FCR was associated with both positive and negative health-seeking behaviours, and emerging evidence supported a relationship between higher FCR and poor emotional functioning.
Limited evidence showed that cognitive behavioural therapy, supportive expressive therapy and a couple-skills intervention helped reduce FCR.
Based on the evidence from this review, clinical practice guidelines are currently under development to provide health professionals with information to support the best practice identification and management of FCR.