Caregiver fear of cancer recurrence: A systematic review and meta-analysis of quantitative studies

Kyra Webb; Louise Sharpe; Phyllis Butow; Haryana Dhillon; Robert Zachariae; Nina Møller Tauber; Mia Skytte O'Toole; Joanne Shaw

doi:10.1002/pon.6176

Caregiver fear of cancer recurrence: A systematic review and meta-analysis of quantitative studies

Psychooncology. 2023 Aug;32(8):1173-1191. doi: 10.1002/pon.6176. Epub 2023 Jun 11.

Authors

Kyra Webb^{1

2}, Louise Sharpe¹, Phyllis Butow^{1

2}, Haryana Dhillon^{1

2

3}, Robert Zachariae^{4

5}, Nina Møller Tauber⁴, Mia Skytte O'Toole⁴, Joanne Shaw^{1

2}

Affiliations

¹ School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
² The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
³ Centre for Medical Psychology & Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
⁴ Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
⁵ Department of Oncology, Unit for Psychooncology and Health Psychology (EPoS), Aarhus University Hospital, Aarhus, Denmark.

PMID: 37303263
DOI: 10.1002/pon.6176

Abstract

Objective: Fear of cancer recurrence (FCR) is reported by both cancer survivors and caregivers however less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels; (b) examine the relationship between caregiver FCR and depression, and anxiety; (c) evaluate psychometric properties of caregiver FCR measures.

Methods: CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/or measurement, published in English-language, peer-review journals between 1997 and November 2022. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy was used to evaluate content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906).

Results: Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between anxiety and depression and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development and psychometric testing. Only one instrument met 50% or more of the criteria, indicating substantial development or validation components were missing in most.

Conclusions: Results suggest FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Caregiver FCR measurement has predominately relied on survivor conceptualisations and unvalidated measures. More caregiver-specific research is urgently needed.

Keywords: cancer; caregiver; fear of cancer recurrence; meta-analysis; oncology; systematic review.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Anxiety
Caregivers*
Fear
Humans
Neoplasm Recurrence, Local
Neoplasms* / therapy
Recurrence