Fear of cancer recurrence in young early-stage breast cancer survivors: the role of metacognitive style and disease-related factors

Psychooncology. 2013 Sep;22(9):2059-63. doi: 10.1002/pon.3252. Epub 2013 Feb 13.

Abstract

Objective: Fear of cancer recurrence (FCR) is a common challenge of cancer survivorship, particularly in younger survivors. Maladaptive metacognitions have been shown to be important to the development of a range of emotional disorders but have not previously been explored in the context of FCR.

Aims: This study aimed to explore the relationship between FCR and a maladaptive metacognitions.

Methods: This cross-sectional study included young women diagnosed with early-stage breast cancer at least 1 year prior to study entry. Participants completed a web-based questionnaire, which included the Fear of Cancer Recurrence Inventory (FCRI) and the brief Metacognitions Questionnaire-30 (MCQ-30). Linear regression was used to calculate unadjusted and adjusted slope estimates of the association of FCR with six metacognition variables, the total score of the MCQ-30 and the five subscales.

Results: Two-hundred and eighteen women with a mean age of 39 years at diagnosis participated. All measures of metacognitive style were moderately correlated with FCRI scores (r=0.31-0.49) and significantly associated with FCRI in both unadjusted and adjusted models. Overall metacognitive style explained 36% of the variance in FCR scores in combination with disease and demographic factors. Negative metacognitions (R(2) =0.32) and need for control over cognition (R(2)=0.26) were the MCQ-30 subscales most associated with higher FCR.

Conclusions: Unhelpful metacognitions appear to play an important role in FCR in young women with early-stage breast cancer. Treatments that focus on changing unhelpful metacognitions may prove a useful approach for treating clinical FCR in cancer survivors in the future.

Keywords: breast cancer; cancer; fear of recurrence; metacognition; oncology.

MeSH terms

  • Adult
  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology*
  • Cognition*
  • Cross-Sectional Studies
  • Fear / psychology*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / psychology*
  • Neoplasm Staging
  • Surveys and Questionnaires
  • Survivors / psychology*