Fear of cancer recurrence is typical decades after a childhood cancer event

One-third of childhood cancer survivors experience fear of recurrence even decades later, according to a study published Oct. 3 in JAMA Network Open.

Alex Pizzo of Concordia University in Montreal and colleagues characterized the prevalence and risk factors for clinically significant fear of cancer recurrence in adult survivors of childhood cancer. The analysis included 229 Childhood Cancer Survivor Study participants (treated at 31 health care facilities between 1970 and 1999).

The researchers found that among surviving patients, 16.6% reported a clinically significant fear of cancer recurrence and another 15.7% reported a high fear of cancer recurrence. An association was found between clinically significant fear of cancer recurrence and unemployment (prevalence ratio [PR] 2.5), presence of neurologic chronic disease (PR, 3.3), treatment with pelvic radiation (PR, 2.9), and amputation or limb-preserving surgery (PR, 2.4). There was also an association between a higher risk of clinically significant fear of cancer recurrence and the presence of either elevated anxiety or depression (PR, 2.6), the presence of simultaneous elevation of both anxiety and depression (PR, 3.2), and perceived poor health status (PR, 3.0).

“The findings suggest that fear of cancer recurrence should be routinely screened and that addressing its clinically significant symptoms should be part of the survivorship care process,” the authors write.