The relationship between illness representations, risk perception and fear of cancer recurrence in breast cancer survivors

Psychooncology. 2017 Sep;26(9):1270-1277. doi: 10.1002/pon.4143. Epub 2016 May 4.

Abstract

Objective: Fear of cancer recurrence, although distinct from distress continues to be under-evaluated, captured, or treated when standard distress scales are used to assess concerns of cancer survivors. We tested a model assessing the association of demographic and clinical factors, illness representations, and perceived risk with fear of cancer recurrence in breast cancer survivors.

Methods: We recruited 117 breast cancer survivors at least one year after completing breast cancer treatment from Internet discussion boards for this cross-sectional, descriptive, correlational study. Participants completed a survey that assessed their level of fear of cancer recurrence as well as their illness representations, perceived risk of recurrence, and demographic and medical characteristics.

Results: Our model explained 62% of the variance in fear of cancer recurrence. Emotional representations (β = .46, p < .01), symptom attribution (β = .21, p < .01), timeline (β = .23, p < .01), and consequences (β = .16, p < .03) were significantly related to fear of recurrence. By contrast, the majority of clinical and demographic variables were not significant contributors to fear of recurrence.

Conclusions: Upon completion of cancer treatment, survivors with more emotional representations of the experience and those who attribute unrelated symptoms to their breast cancer have a higher level of fear of recurrence. Evaluation of these factors during treatment may help mitigate fear of recurrence in the survivorship phase of the breast cancer trajectory. Copyright © 2016 John Wiley & Sons, Ltd.

MeSH terms

  • Adult
  • Breast Neoplasms / psychology*
  • Cancer Survivors / psychology*
  • Cross-Sectional Studies
  • Fear / psychology*
  • Female
  • Health Behavior
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / psychology*
  • Self Report
  • Stress, Psychological / psychology
  • Surveys and Questionnaires