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Cited by 88Cancer survivorship and careChildhood Cancer Survivors' Quality of LifeAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Re‐validation and screening capacity of the 6‐item version of the Cancer Worry Scale

Open access
Custers, José A.E., Kwakkenbos, Linda, van de Wal, Marieke, Prins, Judith B., Thewes, Belinda·2018·Psycho-Oncology
DOI 10.1002/pon.4782
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Abstract

Objective: Fear of cancer recurrence (FCR) is one of the major existential unmet needs of cancer survivors. Due to growing availability of evidenced‐based interventions for high FCR, valid and reliable brief measures of FCR are needed. This study aimed to validate the 6‐item Cancer Worry Scale (CWS) and to establish a cut‐off score for high FCR. Methods: Participants in this study were 1033 cancer survivors and patients recruited as part of 5 existing studies on FCR involving patients and survivors with gastro‐intestinal stromal tumors, colorectal, breast, and prostate cancer. De‐identified data of the CWS, Fear of Cancer Recurrence Inventory (FCRI), Impact of Event Scale, Hospital Anxiety and Depression Scale, and EORTC‐QLQ‐C30 were amalgamated for the analyses. Confirmatory factor analysis of the CWS was performed. Sensitivity and specificity were tested with the FCRI as gold standard. Results: Results confirmed that the 6‐item version of the CWS maintained good construct validity, convergent and divergent validity, and high internal consistency (α 0.90). The optimal cut‐off for the 6‐item CWS was 9 versus 10 using the 12 vs 13 FCRI‐SF score (sensitivity 82%, specificity 83%) and the 15 vs 16 FCRI‐SF score (sensitivity 88%, specificity 73%). Using the highest FCRI‐SF cut‐off (21 vs 22), the optimal CWS cut‐off was 11 vs 12 (sensitivity 88%, specificity 81%). Conclusions: The present results provide researchers and clinicians with a brief valid and reliable measure of FCR which is suitable for measuring FCR in cancer patients and survivors.

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  • The 6-item version of the CWS has good construct, convergent and divergent validity, and high internal consistency to detect fear of cancer recurrence in breast cancer survivors, with a Cronbach alpha coefficient of 0.90.

    “The 6-item version of the CWS has good construct, convergent and divergent validity, and high internal consistency to detect fear of cancer recurrence in breast cancer survivors, with a Cronbach alpha coefficient of 0.90 (Custers et al., 2018).”

    From A randomised controlled trial comparing internet-delivered cognitive behavioural therapy (iCBT) with and without main carer access versus treatment-as-usual for depression and anxiety among breast cancer survivors: Study protocol (2021) · cites this paper as Custers et al., 2018

    The Abstract and §3.2 report good construct, convergent and divergent validity and high internal consistency for the 6-item CWS, with Cronbach’s alpha of 0.90. But §2.1 says the analysis pooled patients and survivors with several cancer types, including breast cancer; the cited results are not specific to breast cancer survivors. Page numbers are unavailable in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The Cancer Worry Scale is well-validated for assessing fear of recurrence in cancer patients and survivors.

    “The Cancer Worry Scale is a 6-item self-report measure designed to assess fear of recurrence in cancer survivors that has been well-validated for use in cancer patients and survivors.33”

    From Psychological flexibility, distress, and coping in ovarian cancer survivors. (2026) · cites this paper as [33]

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Research works printed but not linked: 1

  1. Custers JAE, Gielissen MFM, de Wilt JHW, Prins JB. Fear of cancer recurrence, quality of life and distress in the first year after the diagno- sis of colorectal cancer. Psychooncology. 2015;24(2):91.

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Authors
Custers, J. A. E., Kwakkenbos, L., van de Wal, M., Prins, J. B., & Thewes, B.
Affiliations
  • Radboud University Medical Center (NL)
  • Radboud University Nijmegen (NL)
  • Radboud Institute for Health Sciences, Department of Medical Psychology Radboud University Medical Center Nijmegen The Netherlands
Corresponding author
Custers, José A.E.
ORCID
Venue
Psycho-Oncology
Publisher
Wiley
Published
2018-06-14
Volume
27
Issue
11
Pages
2609-2615
ISSN
  • 1057-9249 (ISSN-L)
  • 1099-1611
DOI
10.1002/pon.4782
OpenAlex
W2807241313
Cited by
88
References
32
Citations by year
2026: 12 · 2025: 16 · 2024: 15 · 2023: 10 · 2022: 20 · 2021: 11 · 2020: 3 · 2018: 1
FWCI
1.41
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Psycho-Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
fear of cancer recurrence, scale validation, cancer survivors, psychometric properties, cut-off values, gastrointestinal stromal tumor, breast cancer, colorectal cancer, prostate cancer
MeSH terms
Cancer Survivors, Adult, Anxiety, Fear, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Phobic Disorders, Psychometrics, Quality of Life, Surveys and Questionnaires, Reproducibility of Results

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