Purpose: This study examined the prevalence and factors associated with fear of cancer recurrence (FCR) in young adults (YAs).
Methods: YAs diagnosed with cancer between the ages of 15 and 39 in Canada (n = 461), who were currently 19 years or older, completed the Young Adults with Cancer in their Prime (YACPRIME) Study. The Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) was the primary outcome. Scores ≥ 16 on the FCRI-SF indicate problematic levels and scores ≥ 22 represent clinically significant FCR. Covariates included demographic, clinical cancer variables, and co-morbid symptom measures. Univariate and multivariate logistic regression analyses were performed to identify variables associated with FCR.
Results: Participants were predominantly female (87%) with a mean age of 32 years (SD = 4.7). Problematic levels of FCR were present in 84% of YAs, and 59% met or exceeded the cutoff for clinically significant FCR. In the multivariate model, time since diagnosis of 5+ years was associated with a reduced likelihood of clinical FCR (Adjusted Odds Ratio [AOR] = 0.354; p = .004), while having a previous recurrence was related to increased likelihood (AOR = 3.468, p = .001). Other factors associated with clinical FCR in YAs were psychological distress (Mild: AOR = 2.947, p = .003; Moderate: AOR = 5.632, p < .0005; Severe: AOR = 8.877, p < .0005), and cancer-related body image dissatisfaction (AOR = 2.311, p = .004).
Conclusions: FCR is a pervasive problem for YAs diagnosed with cancer, with previous recurrence and psychological difficulties as factors associated with a higher degree of fear.
Implications: Psychosocial interventions for YAs targeting depression and anxiety should also prioritize the treatment of FCR.
Keywords: Distress; Fear of cancer recurrence; Psychosocial oncology; Young adults.