Effectiveness of a guided online primary care intervention for fear of cancer recurrence: A randomised controlled trial.
Open accessAbstract
OBJECTIVE: Fear of Cancer Recurrence (FCR) is highly prevalent among cancer survivors and leads to decreased quality of life and increased healthcare costs. We assessed the effectiveness of a guided online primary care intervention for FCR, compared to waiting list. METHODS: In this RCT, participants were recruited online and randomised 1:1. All adults who finished successful curative cancer treatment between 3 months and 10 years ago, wanted support for FCR, and had sufficient Dutch skills were eligible. The intervention consisted of a 10-week online programme and three to five video calling sessions with a trained mental health worker. After 6 months, the control group received the same intervention. The primary outcome was the difference between the groups in the change in FCR severity from baseline (T0) to 6 months (T2), measured online with the short form of the Fear of Cancer Recurrence Inventory. RESULTS: One hundred and seventy-three participants were enroled and randomised to the intervention (n = 86) or control group (n = 87). FCR severity dropped 2.1 points more in the intervention group than in the control group (2.7 points (SD = 3.9) versus 0.6 points (SD = 3.6), t(154) = 3.4, p = 0.0007). General mental well-being also improved significantly in the intervention group and remained stable in the control group. These improvements remained at 10 months follow up. CONCLUSIONS: This easily accessible and relatively inexpensive intervention effectively reduces FCR and has potential to replace or precede existing more intensive psychological treatments, improving patients' access to care. TRIAL REGISTRATION: The trial was prospectively registered in the Netherlands Trial Register on 25-02-2019 with number NL7573.
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The vast majority of reviewed studies took place in a mental health setting, and Luighes-Huizer et al. (2023) were the first to evaluate a psychological FCR intervention in primary care.
“The vast majority of the studies took place in a mental health setting and Luighes-Huizer et al. (2023) were the first to evaluate the impact of a psychological FCR intervention in primary care [61].”
From Web-based interventions for fear of cancer recurrence: A scoping review with a focus on suggestions for the development and evaluation of future interventions (2024) · cites this paper as [61]
The passage labelled 3 | RESULTS says that most FCR interventions are offered in mental healthcare settings and explicitly calls this study the first to evaluate a psychological intervention in primary care. It does not establish the stronger claim that the vast majority of reviewed studies took place in mental health settings. (LLM, conf=0.84)
Experimental — accuracy not yet measuredQualified therapists delivered the intervention in ten reviewed studies, most often alongside website self-guided materials.
“Qualified therapists delivered the intervention in ten reviewed studies, most often alongside the website self-guided materials [37, 43–45, 53, 56, 57, 59, 61].”
From Web-based interventions for fear of cancer recurrence: A scoping review with a focus on suggestions for the development and evaluation of future interventions (2024) · cites this paper as [61]
Section 2.4 (Intervention; page not available) describes an online programme of information, videos and exercises alongside video sessions with mental health workers, supporting this study as an example of guided online care. It does not identify those workers as qualified therapists. As a single trial, it also does not establish the citing sentence’s total of ten reviewed studies or what occurred most often across them. (LLM, conf=0.84)
Experimental — accuracy not yet measuredBeing referred onto trial by treatment team was the most frequent recruitment strategy, followed by social media, cancer patient organisations, reviewing medical records, posters, and leaflets.
“Being referred onto trial by treatment team [33, 45, 55, 59, 67] was the most frequent employed strategy, followed by recruiting participants via social media [46, 55, 56, 61], cancer patient organisations [46, 54, 55, 61], reviewing medical records [57, 58, 60], exhibiting posters [46, 67], disseminating a leaflets [55].”
From Web-based interventions for fear of cancer recurrence: A scoping review with a focus on suggestions for the development and evaluation of future interventions (2024) · cites this paper as [61]
Section 2.2 (Participants; page unavailable) says this trial recruited cancer survivors through social media, cancer patient organizations, and existing cancer cohorts. It does not report recruitment by treatment-team referral or leaflets, although this source is cited for those strategies in the citing sentence. The sentence’s ranking of strategies across trials is not established by this trial alone. (LLM, conf=0.88)
Experimental — accuracy not yet measuredLuigjes-Huizer et al.'s primary care setting FCR intervention effects were visible after 10 months.
“the effects of Luigjes-Huizer et. al’s primary care setting FCR intervention were visible after 10 months [61].”
Luigjes-Huizer et al. found that while FCR severity decreased and participants were generally satisfied with the outcome, many participants still scored above the FCR cutoffs.
“Interestingly, Luigjes-Huizer et al. [61] found that while FCR severity decreased and participants were generally satisfied with the outcome, many participants still scored above the FCR cutoffs.”
In one primary care study using self-referral, 53% of the group started with high FCR despite the intervention being designed for moderate FCR.
“In contrast, one study on an intervention in primary care setting [61] used self-referral their recruitment strategy and found that, while the intervention had been designed for patients with moderate FCR, 53% of the group started with high FCR (FCRI-SF ≥22).”
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- Authors
- Luigjes‐Huizer, Y. L., Helsper, C. W., de Wit, N. J., & van der Lee, M. L.
- Affiliations
- Helen Dowling Institute Bilthoven The Netherlands
- University Medical Center Utrecht (NL)
- Julius Centre for Health Sciences and Primary Care University Medical Centre Utrecht Utrecht The Netherlands
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2023-10-18
- Volume
- 32
- Issue
- 12
- Pages
- 1839-1847
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- OpenAlex
- W4387729265
- Cited by
- 18
- References
- 38
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 4
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psycho-Oncology (publishedVersion, cc-by-nc-nd)
- Research portal (Tilburg University) (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Funders
- KWF Kankerbestrijding
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- fear of cancer recurrence, cancer survivors, online intervention, primary care, video calls, psychological support, health care access
- MeSH terms
- Adult, Fear, Humans, Neoplasm Recurrence, Local, Phobic Disorders, Primary Health Care, Quality of Life, Cognitive Behavioral Therapy
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