Background
Fear of cancer recurrence/progression (FCR/P) is prevalent, and for 10% of survivors severe, distressing and restrictive. People with high FCR/P experience constant intrusive thoughts about cancer recurrence/progression which they feel unable to control. They may not plan for the future because of a perceived imminent need for cancer care. They may avoid follow-up to reduce anxiety or seek excessive screening to obtain reassurance, burdening the health system. Family members and carers may also experience high FCR/P, sometimes more than the patient themselves. Over the past twenty years, theoretically driven interventions have been proven effective, but most are resource intensive. Samples have been dominated by women with breast cancer, with little known about FCR/P in some tumour groups.
Objectives
This overview aims to review the body of evidence concerning FCR/P and highlight recent developments.
Methods
A rapid review of the literature informed this overview, supplemented by discussions with national and international FCR/P interest groups to obtain information about ongoing research.
Results and Conclusions
Current research aims to scale up interventions and provide cost-effective, accessible stepped care using a blended internet and face-to-face format and delivered by diverse health professionals. Intervention adaptations for people with different tumours at varied stages are being developed, including for those with advanced disease. Increased understanding of the unique needs of carers and family members is guiding interventions targeting this group. FCR/P remains a predominant survivorship concern which challenges oncology teams. Education for staff in delivering optimal care to survivors and those living with chronic cancer conditions is needed to help them better manage FCR/P.