Poster Presentation Cancer Survivorship Conference 2023

Fear of cancer recurrence in people attending the Sydney Cancer Survivorship Centre clinic (SCSC) (#163)

Sim Yee (Cindy) Tan 1 2 3 , Haryana Dhillon 4 , Sue Butler 1 5 , Kim Kerin-Ayres 1 6 , Janette Vardy 1 2
  1. Concord Cancer Centre , Concord Hospital, Concord, NSW, Australia
  2. Faculty of Health and Medicine, The University of Sydney, Sydney, NSW
  3. Nutrition and Dietetics Department, Concord Hospital, Concord, NSW, Australia
  4. Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, NSW, Australia
  5. Psychology Department, Concord Hospital, Concord, NSW , Australia
  6. Nursing Services, Concord Hospital, Concord, NSW, Australia

Background:

Fear of cancer recurrence (FCR) is a common concern for cancer survivors.  Here we evaluate FCR in survivors attending the SCSC clinic.

Methods:

A cross-sectional study evaluating FCR in survivors who had completed primary treatment for early-stage cancer attending SCSC initial multidisciplinary survivorship clinic from 12/9/2013 to 10/6/2022.  FCR was measured by: 1. clinical psychologist evaluation; 2. patient reported outcomes (PROs) (FCR7 introduced 1/10/2020). Primary endpoint was presence and severity of FCR based on clinical psychologist review.  Secondary endpoints included PRO FCR and distress (Distress Thermometer).  Associations were sought between FCR, clinical factors and distress.

Baseline characteristics were reported descriptively; chi-square and independent sample t-tests for comparisons between variables.  Fisher exact test evaluated associations between categorical variables and Spearman’s rho correlations between ordinal variables.

Results:

Data from 796 survivors were evaluable: (40% breast; 33% colorectal; 15% haematological; 12% other cancers): 69.5% were female; median age 58 (range:18-90).  Overall, 445/688 (65%) were diagnosed with FCR on psychological assessment; severity rated in 390/445 (88%), as mild 53%, moderate 35%, or severe 12%.  On FCR7 (n=110), mean score was 17.7/40 (SD 7.8)(higher score >FCR; clinically significant score ≥17); 7% rated no FCR (‘zero scorers’), 43% moderate and 50% severe.   Presence of FCR detected by FCR-7 was associated with psychologist assessment Proportion with FCR is significantly higher in: survivors <65 years (74.6% vs 52%, p<0.001); females (71% vs 51%, p<0.005) but not associated with disease stage (p=0.324).  FCR rates varied significantly between tumour groups (73% breast vs 69% haematology, 56% colorectal and 57% others, p<0.001).  Survivors with FCR reported a significantly higher mean distress score than those without FCR (mean difference 1.1/10 (95% CI 0.63 – 1.53). 

Conclusion:

Clinical levels of FCR is prevalent and associated with clinical characteristics. Screening for FCR and provision of evidence-based psychological interventions may help.