Fear of cancer recurrence among young adult cancer survivors-exploring long-term contributing factors in a large, population-based cohort

J Cancer Surviv. 2021 Aug;15(4):497-508. doi: 10.1007/s11764-020-00943-2. Epub 2020 Sep 28.

Abstract

Purpose: Fear of cancer recurrence (FCR) may be debilitating, yet knowledge of FCR among the growing population of long-term young adult cancer survivors (YACS) is scarce. We explored risk of FCR and associated factors in a nation-wide, population-based cohort of YACS.

Methods: All 5-year survivors diagnosed at the ages of 19-39 years with breast cancer (BC), malignant melanoma (MM), colorectal cancer (CRC), leukemia (LEU), or non-Hodgkin lymphoma (NHL) between 1985 and 2009 in Norway were identified by the Cancer Registry of Norway and completed the cross-sectional comprehensive NOR-CAYACS health survey. Univariate and multivariate linear regression modeling was performed.

Results: In total, 936 survivors were included, with an average of 16 years since diagnoses. BC was the most prevalent cancer form (38.4%), followed by MM (24.7%), NHL (15.6%), CRC (11.8%), and LEU (9.6%). Survivors worried most about getting another cancer (74%), and (20%) reported quite a bit or a lot of FCR. BC and MM survivors had the highest FCR scores. Post-traumatic stress symptoms (PTSS) had the strongest association with FCR (Std B 0.21, p < 0.01), above demographic and clinical variables.

Conclusions: FCR is prevalent even among long-term YACS, including survivors of MM with favorable prognoses.

Implications for cancer survivors: Attention to ongoing risks of PTSS and FCR in this growing survivor population is warranted to optimize future survivorship care.

Keywords: Fear of cancer recurrence; Long-term survivors; Post-traumatic stress; YACSs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast Neoplasms*
  • Cancer Survivors*
  • Cross-Sectional Studies
  • Fear
  • Female
  • Humans
  • Neoplasm Recurrence, Local
  • Phobic Disorders*
  • Young Adult