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Fear of recurrence among older breast, ovarian, endometrial, and colorectal cancer survivors: Findings from the WHI LILAC study.

ABSTRACT: OBJECTIVE:To examine the prevalence of and factors associated with fear of recurrence (FCR) following treatment for breast, ovarian, endometrial, and colorectal cancer among older women. METHODS:Participants were enrolled in the Women's Health Initiative Life and Longevity After Cancer study. Descriptive statistics and multivariate logistic regression models were used to assess the association of demographic, clinical, and quality of life variables with survivors' FCR, dichotomized as <14 (low) or ?14 (high) using the Cancer Worry Scale. RESULTS:Out of the 4259 participants, 3124 (73.3%) were diagnosed with breast cancer, 559 (13.1%) with colorectal cancer, 493 (11.6%) with endometrial cancer, and 83 (2%) with ovarian cancer. There were no significant differences in FCR by cancer type (P = .75), with a mean scale score of 10.8 ± 2.87 for all participants combined. Approximately 16% (n = 679) were in the high FCR group. Multivariable analyses indicated that being younger at diagnosis, reporting a symptom score of ?8, receipt of chemotherapy, and lower self-rated health were significantly associated with high FCR. Women who were widowed or never married were less likely to report high FCR. CONCLUSIONS:Fear of recurrence was experienced by a small but important proportion of older, long-term cancer survivors and is associated with multiple demographic and clinical variables. These results will better inform researchers and clinicians regarding the individuals who are at risk of FCR.

SUBMITTER: Krok-Schoen JL

PROVIDER: S-EPMC6939621 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Fear of recurrence among older breast, ovarian, endometrial, and colorectal cancer survivors: Findings from the WHI LILAC study.

Krok-Schoen Jessica L JL Naughton Michelle J MJ Bernardo Brittany M BM Young Gregory S GS Paskett Electra D ED

Psycho-oncology 20180516 7

<h4>Objective</h4>To examine the prevalence of and factors associated with fear of recurrence (FCR) following treatment for breast, ovarian, endometrial, and colorectal cancer among older women.<h4>Methods</h4>Participants were enrolled in the Women's Health Initiative Life and Longevity After Cancer study. Descriptive statistics and multivariate logistic regression models were used to assess the association of demographic, clinical, and quality of life variables with survivors' FCR, dichotomize ...[more]

PMID: 29644766

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Project description:BackgroundFear of recurrence (FoR) is a prevalent concern among breast cancer survivors (BCS) yet few accessible interventions exist. This study evaluated a targeted eHealth intervention, "FoRtitude," to reduce FoR using cognitive behavioral skills training and telecoaching.MethodsBCS (N = 196) were recruited from an academic medical center and 3 National Cancer Institute Community Oncology Research Program community sites, had stage 0-III breast cancer, were 1-10 years post-primary treatment, with moderate to high FoR and familiarity with the internet. Using the Multiphase Optimization Strategy, participants were independently randomized to three cognitive behavioral skill (Relaxation, Cognitive restructuring, Worry practice) versus an attention control condition (health management content; HMC), and to telecoaching (motivational interviewing) versus no telecoaching. Website content was released across 4 weeks and included didactic lessons, interactive tools, and a text-messaging feature. BCS completed the Fear of Cancer Recurrence Inventory (FCRI) at baseline, 4 and 8 weeks. FCRI scores over time were compared using mixed-effects models. All statistical tests were 2-sided.ResultsFCRI scores decreased statistically significantly from baseline to post-intervention (T0=53.1 [SD = 17.4], T2=41.9 [SD = 16.2]; p < 0.001). The magnitude of reduction in FCRI scores was comparable across CBT and attention control HMC conditions and was predicted by increased self-efficacy. Telecoaching was associated with lower attrition and greater website use (mean adherence score = 26.6 [SD = 7.2] vs. 21.0 [SD = 10.5]; p < 0.001).ConclusionsBCS experienced statistically significant reductions in FoR post-intervention, but improvements were comparable between CBT and attention controls. Telecoaching improved adherence and retention. Future research on optimal integration of CBT and HMC, dose, and features of eHealth delivery that contributed to reducing FoR is needed. In the COVID-19 era, remote delivery has become even more essential for reaching survivors struggling with FoR.

Dataset Information

Fear of recurrence among older breast, ovarian, endometrial, and colorectal cancer survivors: Findings from the WHI LILAC study.

Publications

Fear of recurrence among older breast, ovarian, endometrial, and colorectal cancer survivors: Findings from the WHI LILAC study.

Similar Datasets

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