Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the Cancer Survivorship-a multi-regional population-based study
Abstract
BACKGROUND: Fear of recurrence (FoR) is a widespread problem among breast cancer survivors. So far, little is known about prevalence, determinants, and consequences of FoR specifically in long-term breast cancer survivors, even though it was found to be one of the most important concerns in this group. METHODS: Analyses are based on data of several population-based cohorts of long-term breast cancer survivors, recruited by six German cancer registries. Overall, 2671 women were included in the analyses. FoR was assessed using the short form of the Fear of Progression Questionnaire. Potential determinants of moderate/high FoR and the association with depression and quality of life (QoL) were explored via multiple logistic and linear regression. RESULTS: Even though the majority of women reported low levels of FoR (82%), a substantial percentage experienced moderate (11%) and high (6%) FoR. Younger age (odds ratio = 3.00, confidence intervals = 1.91-4.73 for women below age 55 years) and considering oneself as a tumor patient (odds ratio = 3.36, confidence intervals = 2.66-4.25) were found to exhibit the strongest associations with moderate/high FoR. Overall, psychosocial and sociodemographic factors played a far bigger role in FoR than clinical factors. Higher FoR was associated with higher depression and lower QoL. CONCLUSION: Fear of recurrence (mostly low levels) is highly prevalent among long-term breast cancer survivors and can negatively affect QoL and well-being. Therefore, it should be given appropriate consideration in research and clinical practice. As specifically younger women tended to be impacted by FoR, it is crucial to be particularly attentive to specific needs of younger survivors.
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Younger age is associated with higher FCR in breast cancer and other cancer types.
“A systematic review by Crist and Grunfeld [5] revealed that younger age was associated in almost every study with higher FCR for different cancer types, including breast cancer [53–55].”
From Fear of cancer recurrence in breast cancer survivors carrying a BRCA1 or 2 genetic mutation : a cross-sectional study (2024) · cites this paper as [53]
Fear of cancer recurrence is highly prevalent among breast cancer survivors (rates ranging from 52% to 86%) and seems to remain stable over the survivorship trajectory.
“Fear of cancer recurrence is highly prevalent among breast cancer survivors (rates ranging from 52% to 86%) and seems to remain stable over the survivorship trajectory (Simard et al., 2013; Koch et al., 2014).”
From A guided internet-delivered individually-tailored ACT-influenced cognitive behavioural intervention to improve psychosocial outcomes in breast cancer survivors (iNNOVBC): Study protocol (2019) · cites this paper as Koch et al., 2014
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- Authors
- Koch, L., Bertram, H., Eberle, A., Holleczek, B., Schmid-Höpfner, S., Waldmann, A., Zeissig, S. R., Brenner, H., & Arndt, V.
- Affiliations
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
- Cancer Registry of North Rhine-Westphalia (Münster region); Münster Germany
- Leibniz Institute for Prevention Research and Epidemiology - BIPS (DE)
- Krebsregister Saarland (DE)
- Hamburg Cancer Registry; Hamburg Germany
- University Hospital Schleswig-Holstein (DE)
- Cancer Registry Rhineland-Palatinate; Mainz Germany
- German Cancer Research Center (DE)
- ORCID
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2013-11-30
- Volume
- 23
- Issue
- 5
- Pages
- 547-554
- ISSN
- 1057-9249 (ISSN-L)
- OpenAlex
- W1950179185
- Cited by
- 253
- References
- 41
- Citations by year
- 2026: 16 · 2025: 26 · 2024: 15 · 2023: 26 · 2022: 30 · 2021: 22 · 2020: 23 · 2019: 19 · 2018: 13 · 2017: 22 · 2016: 24 · 2015: 7 · 2014: 10
- FWCI
- 7.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- the German Cancer Aid (108262)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- fear of recurrence, breast cancer survivors, long-term survivors, prevalence, risk factors, quality of life, depression, young women, psychosocial factors, sociodemographic factors
- MeSH terms
- Adult, Age Factors, Aged, Breast Neoplasms, Depression, Fear, Female, Humans, Middle Aged, Neoplasm Recurrence, Local, Quality of Life, Risk Factors, Cohort Studies, Prevalence, Odds Ratio, Survivors
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