Fear of Cancer Recurrence: Experiences and Related Factors in Early Stage Lung Cancer Patients

Background: In recent years, early lung cancer became the most common cancer in the worldwide and most of them have psychological problems (anxiety and depression). However, few study was discussed about fear of cancer recurrence (FCR) in the patients after surgery.

Objective: The aim of this study was to explore experiences and related factors of FCR in early stage lung cancer patients in Taiwan.

Methods: A cross-sectional correlation study was conducted and total 200 early stage (stage I-3A) lung cancer patients were recruited in outpatient center after post-surgery. We measured by the structure questionnaire including the Karnofsky performance score (KPS), Hospital Anxiety and Depression Scale (HADS), and Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF, range: 0-36). Using independent t-test, one-way ANOVA, and Pearson’s correlation coefficient to identify the significant factors were related to FCR.

Results: Mean age was 59.4(SD=11.7) years and more than half of patients were male (59.5%), low income (51.5%), non- smoker (71%), unemployment (60.5%), good of pulmonary (FVC=95.6±15.4), and well physical function (KPS>90=70%).

The results revealed most of patients without anxiety or depression problems (mean score:3.8±4.1, 3.8±3.9, respectively) but underwent mild to moderate levels of FCR (mean score: 13.0±6.0). The top severe item in FCRI-SF was “When I think about FCR, other unpleasant thoughts or images come to mind (death, suffering, consequences for my family)”. Younger age, higher education level, anxiety, and depression were significant associated with more serious of FCR. The most use of coping strategy was ” I try to convince myself that everything will be fine or I think positively.” Female, has religious belief, non-smoker, and good pulmonary function were significant related to better of FCR coping strategies.

Conclusions: Age, education, and psychological status (anxiety and depression) were the important factors were associated with FCR, but most patients even had well psychological status not mean that they without FCR problem. In future, the rapid of convenience and brief assessment have to develop and practice in clinical practice, and giving efficient intervention to the patients with higher levels of FCR.

Keywords:anxiety, depression, fear of cancer recurrence, early lung cancer