Description
Fear of cancer recurrence is one of the most common and distressing long-term effects of cancer diagnosis and treatment. The vast majority of cancer survivors fear their cancer will return. While survivorship care plans have been proposed as an important intervention for alleviating the unmet needs of cancer survivors, there is a dearth of evidence supporting the hypothesis that survivorship care plans benefit cancer survivors. The present study explores factors associated with fear of recurrence among adult cancer survivors, with focus on written follow-up advice, which is a key component of survivorship care plans. The theoretical framework for this study is Mishel's Uncertainty in Illness Theory, which seeks to explain how individuals appraise uncertainty and assign meaning to illness-related events. Data analyzed were secondary cross-sectional survey data from the 2010 National Health Interview Survey. The current study focused on a subset consisting of cancer survivors aged 18 or older for a final sample of N = 1808. All data were publicly available through the Centers for Disease Control and Prevention. Statistical analyses included sensitivity analysis, descriptive frequencies, bivariate analyses, and multivariable logistic regression. Only 23.33% of the sample of cancer survivors reported fear of recurrence. The complete multivariable regression model identified several factors that were significantly associated with fear of cancer recurrence including follow-up advice, younger age, receipt of chemotherapy, clinical trial or research study participation, prior recurrence, and receipt of professional counseling or support group participation. However, receipt of a treatment summary, gender, race, ethnicity, and marital status were not associated with fear of cancer recurrence. When adjusting for all covariates, those who received written follow-up advice had 74.1% greater odds of reporting fear of cancer recurrence than those who did not receive follow-up advice (AOR = 1.741; 95% CI = 1.287 - 2.372; p = 0.0004). This finding was surprising given the assumed value of survivorship care plans displayed in the literature. Due to the severity and pervasiveness of fear of cancer recurrence and the complexity of survivorship, future study is warranted.
