Fear of cancer recurrence, anxiety and depressive symptoms in adolescent and young adult cancer patients Neuropsychiatric Disease and Treatment

Background: Previous studies have indicated that younger age is consistently associated with high levels of fear of cancer recurrence (FCR), anxiety and depression. However, the associations among these variables in adolescent and young adult (AYA) cancer patients are not clear. This study explores the prevalence and correlates of FCR, anxiety and depressive symptoms in Chinese AYA cancer population. Methods: This is a cross-sectional study that includes 249 patients aged between 15 and 39 yrs at the time of cancer diagnosis. Patient ’ s sociodemographic, clinical as well as psychological characteristics were collected by an information sheet, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), General Anxiety Disorder Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9). Descriptive statistics and multivariate analyses were conducted. Results: Eighty-nine (35.74%) patients experienced dysfunctional level of FCR, eighty-two (32.93%) patients experienced anxiety symptoms and ninety-six (38.55%) reported depressive symptoms. In multivariate analyses, being single, pessimistic, having more concurrent stressful life events and physical comorbidity were independently associated with higher FCR, anxiety and depressive symptoms. Patients who were not engaging in radiotherapy were more likely to report higher anxiety level. Conclusion: FCR, anxiety and depressive symptoms are frequently reported problems among AYA cancer patients. Age-appropriate and fl exible psychological interventions are needed for this high-risk population.

[1]  G. Humphris,et al.  Fear of cancer recurrence in adolescent and young adult cancer survivors: A systematic review of the literature , 2019, Psycho-oncology.

[2]  G. Daeschlein,et al.  Influence of Treatment Caused Impairments on Anxiety and Depression in Patients with Cancer of the Esophagus or the Esophagogastric Junction , 2019, Journal of Gastrointestinal Cancer.

[3]  Bin Zhang,et al.  Factors associated with fear of progression in chinese cancer patients: sociodemographic, clinical and psychological variables. , 2018, Journal of psychosomatic research.

[4]  L. Ljungman,et al.  Women treated for gynaecological cancer during young adulthood - A mixed-methods study of perceived psychological distress and experiences of support from health care following end-of-treatment. , 2018, Gynecologic oncology.

[5]  J. Custers,et al.  Prevalence and correlates of high fear of cancer recurrence in late adolescents and young adults consulting a specialist adolescent and young adult (AYA) cancer service , 2017, Supportive Care in Cancer.

[6]  G. Humphris,et al.  The relationship between cancer patient's fear of recurrence and chemotherapy: A systematic review and meta-analysis. , 2017, Journal of psychosomatic research.

[7]  G. Humphris,et al.  The relationship between cancer patient's fear of recurrence and radiotherapy: a systematic review and meta‐analysis , 2017, Psycho-oncology.

[8]  G. Basso,et al.  Self-Esteem and Academic Difficulties in Preadolescents and Adolescents Healed from Paediatric Leukaemia , 2017, Cancers.

[9]  U. Koch,et al.  Anxiety and depression in working-age cancer survivors: a register-based study , 2017, BMC Cancer.

[10]  T. Reinfjell,et al.  A Review of Demographic, Medical, and Treatment Variables Associated with Health-Related Quality of Life (HRQOL) in Survivors of Hematopoietic Stem Cell (HSCT) and Bone Marrow Transplantation (BMT) during Childhood , 2017, Front. Psychol..

[11]  Crystal L. Park,et al.  Moderating effects of perceived growth on the association between fear of cancer recurrence and health-related quality of life among adolescent and young adult cancer survivors , 2017, Journal of psychosocial oncology.

[12]  S. Vernon,et al.  Prevalence and correlates of fear of recurrence among adolescent and young adult versus older adult post-treatment cancer survivors , 2016, Supportive Care in Cancer.

[13]  J. Dekker,et al.  Factors associated with anxiety and depressive symptoms in colorectal cancer survivors , 2016, European journal of gastroenterology & hepatology.

[14]  P. Butow,et al.  From normal response to clinical problem: definition and clinical features of fear of cancer recurrence , 2016, Supportive Care in Cancer.

[15]  J. Giese-Davis,et al.  The Age Conundrum: A Scoping Review of Younger Age or Adolescent and Young Adult as a Risk Factor for Clinical Distress, Depression, or Anxiety in Cancer. , 2015, Journal of adolescent and young adult oncology.

[16]  J. Custers,et al.  The Cancer Worry Scale: Detecting Fear of Recurrence in Breast Cancer Survivors , 2014, Cancer nursing.

[17]  P. Butow,et al.  Psychological morbidity and stress but not social factors influence level of fear of cancer recurrence in young women with early breast cancer: results of a cross‐sectional study , 2013, Psycho-oncology.

[18]  Gerry Humphris,et al.  Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies , 2013, Journal of Cancer Survivorship.

[19]  U. Koch,et al.  Self‐efficacy and fear of cancer progression during the year following diagnosis of breast cancer , 2013, Psycho-oncology.

[20]  H. Brenner,et al.  Fear of recurrence and disease progression in long‐term (≥5 years) cancer survivors—a systematic review of quantitative studies , 2013, Psycho-oncology.

[21]  W. Linden,et al.  Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. , 2012, Journal of affective disorders.

[22]  B. Löwe,et al.  The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. , 2010, General hospital psychiatry.

[23]  J. Das-Munshi,et al.  Prevalence of mental health conditions in cancer patients in acute care--a meta-analysis. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[24]  M. Pinquart,et al.  Depression and cancer mortality: a meta-analysis , 2010, Psychological Medicine.

[25]  A. Mehnert,et al.  Fear of cancer progression and cancer‐related intrusive cognitions in breast cancer survivors , 2009, Psycho-oncology.

[26]  A. Dinkel,et al.  Group Psychotherapy of Dysfunctional Fear of Progression in Patients with Chronic Arthritis or Cancer , 2009, Psychotherapy and Psychosomatics.

[27]  J. Temel,et al.  Behavioral and psychological predictors of chemotherapy adherence in patients with advanced non-small cell lung cancer. , 2008, Journal of psychosomatic research.

[28]  P. Butow,et al.  The development and evaluation of a measure to assess cancer survivors' unmet supportive care needs: the CaSUN (Cancer Survivors' Unmet Needs measure) , 2007, Psycho-oncology.

[29]  P. Butow,et al.  Breast cancer survivors’ supportive care needs 2–10 years after diagnosis , 2007, Supportive Care in Cancer.

[30]  T. Kershaw,et al.  A family‐based model to predict fear of recurrence for cancer survivors and their caregivers , 2007, Psycho-oncology.

[31]  B. Löwe,et al.  A brief measure for assessing generalized anxiety disorder: the GAD-7. , 2006, Archives of internal medicine.

[32]  Louis J. Wagner,et al.  Cancer‐related health worries and psychological distress among older adult, long‐term cancer survivors , 2006, Psycho-oncology.

[33]  L. Carlson,et al.  Emotional distress: the sixth vital sign—future directions in cancer care , 2006, Psycho-oncology.

[34]  H. Sommer,et al.  Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[35]  M. Dimatteo,et al.  Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. , 2000, Archives of internal medicine.

[36]  B. Green,et al.  Trauma history as a predictor of psychologic symptoms in women with breast cancer. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[37]  C. Carver,et al.  Optimism versus pessimism predicts the quality of women's adjustment to early stage breast cancer , 1994, Cancer.

[38]  C. Carver,et al.  How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. , 1993, Journal of personality and social psychology.

[39]  P. Engstrom,et al.  Mammography adherence and psychological distress among women at risk for breast cancer. , 1993, Journal of the National Cancer Institute.

[40]  M. Horowitz,et al.  Impact of Event Scale: A Measure of Subjective Stress , 1979, Psychosomatic medicine.

[41]  A. Hutchinson,et al.  Fear of cancer recurrence and psychological well‐being in women with breast cancer: The role of causal cancer attributions and optimism , 2018, European journal of cancer care.

[42]  A. Dinkel,et al.  Fear of progression. , 2014, Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer.

[43]  C. Jianxin,et al.  Reliability and validity of Chinese version of the Generalized Anxiety Disorder 7-item (GAD-7) scale in screening anxiety disorders in outpatients from traditional Chinese internal department , 2013 .

[44]  HU Chao-bing The Factorial Structure Study of the Positive Personality Traits Questionnaire for Chinese College Students , 2013 .

[45]  A. Mehnert,et al.  [Fear of progression in breast cancer patients--validation of the short form of the Fear of Progression Questionnaire (FoP-Q-SF)]. , 2006, Zeitschrift fur Psychosomatische Medizin und Psychotherapie.

[46]  J. Holland,et al.  Psychological distress and surveillance behaviors of women with a family history of breast cancer. , 1992, Journal of the National Cancer Institute.