Predicting fear of cancer recurrence in gynaecological cancer survivors

Abstract

Background: Despite high 5-year survival for some gynaecological cancers (</- 82%), little research addresses survivorship concerns in this group. Fear of cancer recurrence (FCR) has been ranked the largest concern/unmet need for gynaecological cancer survivors, evidencing associations with poor quality-of-life and increased psychological morbidity. Aim: To investigate predictors of FCR in early-to-mid stage gynaecological cancer survivors including the under-researched impact of psychological flexibility, coping styles, and single-item interpretations of illness. Methods: Using a cross-sectional postal-questionnaire, 145 women completed demographics and standardised measures of FCR (FCRI), cancer coping styles (MAC), interpretation of illness (IIQ), psychological flexibility (AAQ-II), and mood (DASS21). Results: A majority of participants (M = 61 years) were married (53.3%) with children, had a tertiary education (31.1%), and were not currently working (60.0%). Diagnoses were mixed, time since diagnosis ranged from 1-32 years (M = 5 years) with 15.9% acute survivors (<1 year postdiagnosis). A linear regression, including eight predictors with moderate-tolarge univariate associations (r >/-.40), evidenced a significant model (p = .000) accounting for 63% of the variance on FCR (adjusted R2). Significant individual predictors included greater anxiously preoccupied coping style (beta = .51), 'threat/enemy' interpretations of cancer (beta = .17), poorer quality-of-life (beta = -.18), and greater fatalistic coping (beta = .14). Other predictors (depression, helpless/hopeless coping, 'punishment' interpretations, and psychological flexibility) were not significant. Conclusions: Compared to FCRI norms, participants appeared less concerned about cancer recurrence despite most being extended/permanent survivors (1+ years post-diagnosis), perhaps reflecting accurate expectations of good survival among gynaecological cancer survivors compared with other cancer types. Respondents' anxiously preoccupied coping style best predicted FCR, potentially highlighting a focus for intervention. Although single-item 'threat/enemy' interpretations of cancer appeared predictive of FCR and could act as a quick screening item, prediction was small-tomoderate in size, thus research into the previously proposed screening ability of the 9-item FCRI Severity subscale is warranted to determine the better tool.