Fear of cancer recurrence: a theoretical review and its relevance for clinical presentation and management

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Abstract

There is increasing recognition of the unique physical and psychosocial concerns of the growing population of cancer survivors. An emerging literature demonstrates that fear of cancer recurrence (FCR) is a problematic long-term and late effect for cancer survivors. In fact, FCR is a top concern, and this article provides a necessary synthesis of the extant research evidence and theory.

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Jeff Greenberg, Tom Pyszczynski, Sheldon Solomon (1986)

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Fear of Cancer Recurrence Inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence.

Sébastien Simard, Josée Savard (2009)

Despite the fact that the fear of cancer recurrence is to varying degrees almost universal in cancer survivors, there is a lack of validated multidimensional instruments to evaluate this issue specifically. The goal of this study was to develop and empirically validate a multidimensional self-report scale for assessing the fear of cancer recurrence, the Fear of Cancer Recurrence Inventory (FCRI). A provincial medical databank was used to randomly select a pool of 1,704 French-Canadian patients who had been treated for breast, prostate, lung, and colorectal cancer within the past 10 years. Of these, 300 patients were asked to complete the FCRI on two occasions. The factorial analysis conducted on the final 42-item scale revealed a seven-component solution (64% of the variance) including the following factors: triggers, severity, psychological distress, coping strategies, functioning impairments, insight, and reassurance. The results also supported the internal consistency (alpha = 0.95) and the temporal stability (r = 0.89) of the FCRI, as well as its construct validity with other self-report scales assessing fear of cancer recurrence (r = 0.68 to 0.77) or related constructs such as psychological distress (r = 0.43 to 0.77) and quality of life (r = -0.20 to -0.36). This study suggests that the French-Canadian version of the FCRI is a reliable and valid instrument for evaluating the multidimensional aspects of the fear of cancer recurrence.