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Change over time of fear of cancer recurrence in prostate cancer survivors: Are there clinical predictors?

Fradet, Knight SJ, Carroll PR. Change over time of fear of cancer recurrence in prostate cancer survivors: Are there clinical predictors? Presented at: Genitourinary Cancer Annual Symposium; 2008 Feb 14; San Francisco, CA.


Background: Fear of cancer recurrence is a common experience among men diagnosed with prostate cancer, but little is known about what clinical factors contribute to its evolution in time. In this retrospective cohort study, we sought to identify clinical predictors of fear of cancer recurrence evolution in time among men diagnosed with prostate cancer and treated with curative intent. Methods: Patients were treated with curative intent (radical surgery, radiation therapy or brachytherapy) from 1995 to 2002, and had completed at least two follow-up measures of fear of cancer recurrence. Linear regression models were used to estimate the magnitude of change in fear of cancer recurrence, according to demographic and clinical characteristics, including age at diagnosis, race, household income, education level, active relationship, prostate cancer risk category, treatment type, cancer recurrence status, and time since treatment. Results: Our final cohort included 2,032 patients, of which 170 have documented disease recurrence before last questionnaire. The mean follow-up time was 30.3 months. Overall, 825 (41%) patients demonstrated greater fear, 508 (26%), no change and 659 (33%), lower fear or cancer recurrence. Experiencing a cancer recurrence and having a family income higher than $75,000 annually were respectively associated with a 1.4 (4%) and 0.5 (1%) augmentation in the fear of cancer recurrence score. Only experiencing a cancer recurrence was associated with a decrease in certainty of 0.4 point (5%) in the feeling cured of cancer question. Having answered the first questionnaire within 4 months or treatment, although statistically significant, did not affect the magnitude of any other potential predictor. All other clinical variables, including cancer risk category and treatment type, did not reach statistical significance. Conclusions: Fear of cancer recurrence changes significantly to higher level upon documented recurrence. Initial clinical cancer and demographic characteristics do not appear to predict fear of recurrence change through time.

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