Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S & Ozakinci G. (2013). Fear of Cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. Journal of Cancer Survivorship. DOI 10.1007/s11764-013-0272-z
Article characteristics /
Sample characteristics
/Method characteristics
/ ResultsAuthors, years
Design / Objectives / Cancer site
Time since dx/tx
Treatment type
Stage/severity
Gleason/PSA
Menopausal status
Comorbidity / N
Participation rate
Country
Gender
Mean age (SD)
Ethnicity
Education
Marital status
Income
Employment / Selection criteria
Group / Procedure of recruitment and assessment
Time of assessment / FCR measure / Outcomes measure explored in association with FCR / Analysis & Results associated with FCR
(Alfano, McGregor et al. 2006)
Cross Sectional / To evaluate the psychometric properties of the Brief Cancer Impact Assessment (BCIA). / Breast
40.5 (6.5) months post-dx
31.7% S
37.3% S+RT
21.8% S+RT+CT
9.2% S+CT
21.7% In situ
57.0% Localised
21.3% Regional/distant
NA
76.2%Menopausal
NA / 783
66% of solicited
USA
100% Women
55.6 (10.4) years
61.8% White
23.0% Black
12.1% Hispanic
25.7% High school or less
58.6% Married/partnered
55.3% ≤$50,000
57.8% Employed / (1) new dx of in situ or Stage I-IIIA breast cancer
(2) first primary dx of cancer / Women were enrolled in the Health, Eating, Activity and Lifestyle (HEAL) study
Data derive from three data collection: baseline, 24-months and average 35-months follow-up
In person interview, telephone and mail assessments were conducted / Fear of Recurrence Questionnaire (FRQ) -Short form
Range: 1 (strongly agree) to 5 (strongly disagree)
Sum: 5-25 / Brief Cancer Impact Assessment (BCIA) / Determinant:Correlations
[+] Caregiving/Finances impact (r = - 0.21)***
[+] Exercise/Diet impact (r = -0.10)**
[+] Social/Emotional impact (r = -0.23)***
[≠] Religiosity impact
(Armes, Crowe et al. 2009)
Longitudinal / To estimate prevalence and severity of patients’ self-perceived supportive care needs and identify predictors of unmet needs. / Mixed: breast, prostate, colorectal, gynaecologic non-Hodgkin’s lymphoma
NA
15% RT
14% S+RT
23% S+RT+HT
13% S+RT+CT+HT
NA
NA
42% Had comorbidies / 1152
62% of solicited
UK
69% Women
60.8 (11.6) years
96% White
37% no formal qualifications
NA
NA
NA
NA / (1) dx of breast, prostate, colorectal, gynaecologic or non-Hodgkin’s lymphoma cancer
(2) aware of their dx and receiving curative tx
(3) metastasis-free and no experience of relapse
(4) receiving last cycle of CT or episode of RT
(5) clinician agreed to participation / Patients were approached by nurses in the clinical setting at the end of tx
Questionnaires were completed at home and to be mailed back.
T1: End of tx
T2: 6-months / FRQ
Range: 1 (strongly agree) to 5 (strongly disagree)
Sum: 22-110 / Supportive Care Needs Survey (SCNS) / Descriptive:
FCR is the most common endorsed unmet needs (T1 = 30%; T2 = 26%)
FCR score: T1= 73.8 (14.7); T2 = 63.7 (6.1)
Course:t test
[-] T1 vs T2 (difference -11)***
Consequence: Logistic Regression
FCR at T1predicted dimensions of unmet needs at T2
[+] Psychological (β = 0.027; OR 1.03)***
[+] Information and health system (β = 0.028; OR 1.03)***
[+] Care (β = 0.026; OR 1.03)***
[≠] Physical
[≠] Sexuality
(Ashing-Giwa and Lim 2011)
Cross-sectional / To describe emotional concerns among a multiethnic sample of breast cancer survivors and to examine differences in emotional items according to demographic characteristics. / Breast
3.0 (1.7) years post-dx
NA
36% Stage I
38% Stage II
14% Stage III
NA
NA
NA / 703
58% of eligible patients
USA
100% Women
55.0 (11.3) years
25.5% European
19.2% African
26.0% Latina
29.3% Asian
25% High school or less
65% Partnered
49% ≤$45,000
49% Employed / (1) within 1-5 years of breast cancer dx and currently cancer-free
(2) stage 0-III
(3) not diagnosed with another cancer or major disabling medical or psychiatric condition / Recruited from the California Cancer Surveillance Program, hospital cancer registries and community agencies
Participants completed either a telephone survey or mailed survey / One item: “I worry that my condition will get worst” in Functional Assessment of Cancer Therapy (FACT-G)
Range : 0 (not at all) to 4 (very much)
Lower score indicating higher FCR / Descriptive:
FCR is the most concerns
FCR score: 2.95 (1.2)
Determinant: χ2
Higher FCR (Low quartile)
[+] Ethnicity: Latina vs European, African and Asian **
[+] Language: Other vs English *
[-] Income: Less than 25000 vs Higher *
[-] Education: Less than high school vs more*
[-] Age: 49 or younger vs older *
[≠] Marital status
[≠] Employment
(Avis, Smith et al. 2005)
Cross-sectional / To develop a measurement tool to assess QoL factors of long term cancer survivors. / Mixed: breast, prostate, gynaecological, bladder, colorectal, head and neck
12.6 (7.0) years post-dx
92.4% S
48.7% RT
23.7% CT
12.3% HT
18.7% Stage I
9.2% Stage II
6.7% Stage III
3.3% Stage IV
62.1% don’t know
NA
NA
NA / 242 (phase II)
9.3% of contact letters
USA
58% Women
71.4 (11.5) years
85.5% White
7.9% Hispanic
6.2% African
42.5% High school or less
65.7% Partnered
NA
21.6% Employed
67.2% Retired / (1) dx of breast, prostate, gynaecological, bladder, colorectal or head and neck
(2) > 5 years post-dx (1994 or earlier) / Recruited through the Florida Cancer Data System by mail
Patient completed Self-reported questionnaires and returned survey / Distress recurrence subscale of the Quality of Life in Adult Cancer Survivors (DRS-QLACS)
Range: 1 (never) to 7 (always)
Sum: 4-28 / QLAC(higher score = higher problems or lower QoL)
Visual analogue scale (VAS) of QoL / Descriptive:
FCR score: 11.4 (6.1)
Determinant:Correlations, ANOVA
[+] Negative feelings (r = 0.48)*
[+] Cognitive problems (r = 0.37)*
[+] Sexual problems (r = 0.26)*
[+] Physical pain (r = 0.41)*
[+] Fatigue (r = 0.32)*
[+] Social avoidance (r = 0.36)*
[+] Appearance concerns (r = 0.40)*
[+] Financial problems (r = 0.40)*
[+] Distress-family (r = 0.46)*
[+] Benefits (r = 0.26)*
[-] Positive feelings (r = -0.26)*
[-] VAS QoL (r = -0.23)*
[≠] by cancer types (F = 1.78)
(Baker, Denniston et al. 2005)
Cross-sectional / To evaluate problems that adult survivors face in dealing with cancer and tx 1 year after dx and to examine the relationship between demographics, cancer type and psychosocial problems. / Mixed: bladder, breast, colorectal, kidney, lung, melanoma, non-Hodgkin lymphoma, ovarian, prostate, uterine
1.03 (0.19) years post-dx
21.0% receiving tx
NA
NA
NA
NA / 752
47.9% of eligible
USA
59.3% Women
50% 18-54 years
88.3% White
9.8% African
46% College or less
73.9% Married/partnered
46.6% ≤ $39,999
NA / (1) ≥18 years
(2) diagnosed within a specified 1 year period with one of the 10 most common cancers / Recruited through cancer registry of three states by mail
Patient completed self-reported questionnaires and returned survey by mail / Fear of recurrence subscale of the Cancer Problems in Living Scale (FRS-CPILS)
Range: 0 (not a problem) to 2 (severe problem) / Cancer Problems in Living Scale (CPILS) / Descriptive:
“Concerns” is ranked as the third most frequent problems: 59.8% of survivors reported ‘somewhat of a problem’ or a ‘severe problem’
“Fearful” is ranked as the first most frequent problems: 68.1% of survivors reported ‘somewhat of a problem’ or a ‘severe problem’.
Determinant: χ2, OR
[-] Age: (18-54 yearsvs ≥ 55 years) **
‘concern’ (OR = 1.6); ‘fearful’ (OR = 1.5)
[+] Gender (women vs men)**:
‘concern’ (OR = 1.3); ‘fearful’ (OR = 1.3)
[+] Treatment (currently vs not)**:
‘concern’ (OR = 1.5); ‘fearful’ (OR = 1.6)
[≠] Race (white vsother)
[≠] Marital status (Married vsother)
[≠] Education (> high school vs ≤ high school)
[≠] Income (< $20000 vs. ≥ $20000)
(Befort, Austin et al. 2011)
Cross-sectional / To describe weight status and methods used for weight control in rural breast cancer survivors and to examine psychosocial factors in this population associated with weight change since breast cancer dx. / Breast
3.2 (2.5) years post-tx
95% S
63% RT
38% CT
52% HT
43% Stage I-III
11% Stage IV
NA
95% menopausal
NA / 918
79-85% of solicited
USA
100% Women
65.9 (13.1) years
96% White
40% High school or less
67% Married
NA
44% Employed
48% Retired / (1) treated for breast cancer within the past 6 years
(2) resided in a rural area / Recruited through three cancer center located in rural Kansas by mail
Patient completed self-reported questionnaires and returned survey by mail
Reminder two weeks and 1-month after initial mailing / One question with FCR as a possible answer: “Which of the following experiences have impacted you as a survivor?”
Range: yes/no / Home questionnaire to assess physical and psychological impact of breast cancer
An adaptation of the National Health and Nutrition Examination Survey / Descriptive:
FCR was experienced by 52% of the total sample
Determinant:t-test
[+] Weight change since dx: 4.4 (21.9) Kgfor those FCR impacted vs 0 (19.2)Kgfor those FCR did not impact**
(Befort and Klemp 2011)
Cross-sectional / To examine the physical and psychosocial effects of breast cancer experienced by rural survivors at the time of tx and currently, based on menopausal status at dx. / Breast
3.2 (2.5) years post-dx
95% S
63% RT
38% CT
52% HT
NA
NA
95% Menopausal
NA / 770
83% of solicited
USA
100% Women
66.6 (13.0) years
97% White
40% High school or less
66% Married
NA
43% Employed
50% Retired / (1) treated for breast cancer within the past 6 years
(2) resided in a rural area / Sub-sample of (Befort, Austin et al. 2011) / One question with FCR as a possible answer: “Which of the following experiences have impacted you as a survivor?”
Range: yes/no / Home questionnaire to assess physical and psychological impact of breast cancer. / Descriptive:
FCR was the most common concerns (52%)
Determinant: Logistic Regression
[+] Premenopausal (68%) more likely report FCR than menopausal (47%) ***
Adjusted for HT, CT and time since dx
(Bellizzi, Latini et al. 2008)
Longitudinal / To examine the contributions of FCR and tx-related symptoms to the health related QoL of men treated for localised prostate cancer. / Prostate
NA
77% RP
5% RT
18% BT
100% Localised
70% ≤10 ng/mLPSA
NA
55% Had comorbidities / 730
NA
USA
100% Men
63.2 (7.7) years
92% White
35% High school or less
NA
NA
NA / (1) diagnosed with localised prostate cancer between 1999 and 2002
(2) underwent RP, BT or RT monotherapy / Recruited through
30 community and academic-based urology practices in USA by mail (CaPSURE)
Patients completed self-reported questionnaires every 6 months and returned survey by mail
T1: Pre-tx
T2: 1 year post-tx / Fear of Relapse/ Recurrence scale (FRRS)
Range: 1(strongly agree) to 5 (strongly disagree)
Transformed: 0-100 / Rand Health Survey (SF-36)
Prostate Cancer Index (PCI) / Descriptive:
FCR score: pre-tx 36.1 (18.3); 1-year 23.5 (18.6)
Course:
[-] T1 vs T2 = difference -12.53 (17.5)**
Consequence: Regression
[-]FCR predicted mental QoL**
[≠] FCR not predicted physical QoL
Adjusted: age, education, race, income, marital status, insurance, clinical risk group at dx, BMI
(Bergman, Gore et al. 2009)
Longitudinal / To examine the impact of a strong and supportive relationship on QoL outcomes in prostate cancer patients. / Prostate
NA
65% RP
16% RT
19% BT
69% Localized
82% < 10 ng/mL PSA
NA
NA / 476
82%
USA
100% Men
63.0 (8.0) years
84% White
90% College or more
85% Partnered
NA
60% Employed / (1) biopsy-proven
prostate cancer
(2) no metastasis
(3) no previous cancer tx / Recruited from March 1999 – January 2003
Patients completed prospectively self-reported questionnaires at 1,2,4,8,12,18,24,30,36, 42 and 48 months after tx.
T1: pre-tx
T2: 1 year post-tx / Fear of recurrence scale of Memorial Anxiety Scale for Prostate Cancer (FRS-MAX-PC)
Range: 1 (strongly agree) to 3 (strongly disagree)
Transformed: 0-100: higher score = lower FCR / Descriptive: t-test
[≠] Partnered = 71.0 (20.0) vs unpartnered = 66.0 (21.0)
[≠] Course
Determinant:Multiple Regression
Predictor of High FCR at baseline
[-] Partnered (PE = 5.79)*
[+] Presence of comorbidity (PE = -4.39)*
[+] PSA(PE = -6.65)**
[≠] Age, race, education, employment, stage, Gleason, BT, RT
Predictor of change in FCR at 12 months
[+] Baseline FCR score(PE = -0.40)**
[+] Stage(PE = -3.76)*
[+] BT (PE = -4.97)*
[≠] Partnership, age, race, education, employment,Gleason, PSA, comorbidity, RT
(Biglia, Cozzarella et al. 2003)
Cross-sectional / To determine the prevalence of menopausal symptoms, and to explore the attitudes toward Hormone Replacement Therapy (HRT). / Breast
NA
NA
100% Stage I-II
NA
56%Menopausal
NA / 250
NA
Italy
100% Women
NA
NA
NA
NA
NA
NA / (1) breast cancer stages I-II
(2) currently disease free
(3) no other serious medical or psychiatric conditions / Recruited through two cancer center of Turin
Patients were interviewed by trained interviewer / Single item:
“Are you concerned about having a recurrence of breast cancer?”
Range: 1 (not at all) to 4 (extremely) / Questionnaire –based interview / Descriptive:
FCR is the major concerns (75%)
FCR is the more frequent reason to against HRT for postmenopausal (33%) and premenopausal women (43%)
Determinant: χ2
[≠] Menopausal (75%) vs premenopausal (64%)
(Bloom, Stewart et al. 2004)
Longitudinal / To compare QoL measures in breast cancer patients after dx and 5 years post-dx. / Breast
NA
51% RM
49% BCS
53% CT
55% RT
38% HT
17% in situ
45% Local
37% Regional
NA
NA
NA / 185
73% of eligible
USA
100% Women
Median 45 years
69% White
16% Asian
5% Black
9% Latina
18% High school or less
65% Married
NA
81% Employed / (1) diagnosed at < 50 years old
(2) cancer-free 5 years post-tx / Follow participants in a study of women diagnosed at age 50 or younger
Patients were re-interviewed 5 years later initial participation
T1: Pre-tx
T2: 5 years post-tx / Worry about Future and Recurrence subscales of the Schain’s problems scales (WRS)
Range: NA / SF-36 / Descriptive:
Pre-tx score = 1.86 (1.1)
5 years post-tx score = 1.41 (1.2)
Course:t-test
[-] Time since tx***
Consequence: Multiple Regression
[≠] Physical well-being changes
[≠] Mental well-being changes
Controlled: age, race, education, stage, surgery, adjuvant tx, baseline physical and mental well-being
(Bölter, Lange et al. 2010)
Cross-sectional / To examine the difference in levels of fear of progression and fear of relapse between patients treated with curative intent and those with advanced disease. / Mixed: breast, gynaecological, lung, prostate, testicular, haematological, other
Curative group: 4.4 months post-dx
Palliative group = 3.9 months post-dx
NA
75% = Curative
25% = Palliative
NA
NA
NA / 291
33% of solicited
Germany
47.9% Women
60.83 (10.5)- 64.46 (11.3) years
NA
29.6%-35.5% University
71.8%-73.3% Married
NA
66.2%-67.3% Retired / (1) ≥ 18 years
(2) dx of cancer between 4 weeks to 1 year / Identified patients through regional cancer centre with city and rural clinics
Questionnaire given to patients at clinic with reply paid envelope / Fear of Progression Questionnaire -Short form (FoP-Q-SF)
Range: 1 (never) to 5 (very often)
FRRS
Range:
1( strongly agree) to 5 (strongly disagree) / Descriptive:
FoP-Q score:
Curative: 2.44 (0.72)
Palliative: 2.49 (0.76)
FRRS score:
Curative: 2.52 (0.81);
Palliative: 3.10 (0.83)
Determinant:t-test
[≠] Current stage with FoP-Q
[+] Current stage **** with FRRS
(Brandberg, Damato et al. 2004)
Cross-sectional / To develop a question module for measurement of QoL among patients with uveal melanoma. / Uveal
NA
20% Enucleation
46% BT
18% Proton irradiation
NA
NA
NA
NA / 61
NA
International: Finland, Sweden,UK
48% Women
61.7 (29-83) years
NA
NA
NA
NA
NA / Uveal melanoma / Recruited in three tertiary referral centres for patients with eye cancer
Patients completed questionnaires and a structured interview at a regular follow-up appointment / Worry about recurrent subscale of the EORTC-Ophthalmic module (WRD-OPT 30)
Range : 0 (not at all) to 4 (very much) / EORTC-QLQ-OPT37 / Descriptive:
Health in future = 2.1 (range =3)
Tumour recurring in eye = 2.1 (range =3)
Tumour in other body parts = 2.3 (range =3)
Worried about losing the eye = 2.4 (range =3)
(Burstein, Gelber et al. 1999)
Longitudinal / To investigate the uses of complementary or alternative medicine (CAM) in those women with early-stage breast cancer and the decision process that is undertaken when deciding on tx. / Breast
NA
34.6% RM
65.4% BCT
57.3% Stage I
42.5% Stage II
NA
65% Menopausal
53.3% Had comorbidities / 480
69% of solicited
USA
100% Women
38.8% < 50 years
22.3% 51 – 60 years
19.4% 11 – 70 years
19.6% > 70 years
96% White
29.8% High School
60.4% Married
40% $40,000
NA / Breast cancer stages I-II between Sept 1993 – 1995 / Recruited from population based study of tx choices inMassachusetts
Patients were assessed at 3-month and 12-month after surgery by mailed questionnaires
T1: 3 months post-surgery
T2: 1 year post-surgery / Fear of Recurrence Index (FRI)
Range: 1 (very much) to 4 (not at all)
Sum: 3-12 / SF-36
Center for Epidemiologic Studies Depression Scale (CES-D)
Symptom Checklist
Questionnaire about use of alternative medicine / Determinant: χ2
[+] Healing therapies at 3 months
Nonusers (7.6) vs New users (8.0)***
[≠]Healing therapies at 12 months
[+]Psychological therapies at 3 months
Nonusers (7.5) vs New users (8.2)***
[+]Psychological therapies at 12 months
Nonusers (7.4) vs New users (7.8)***
Consequence: Logistic Regression
[+] FCR ** ; depression and number of symptom predicted use of CAM Psychological therapy (mental process)
[≠] FCR don’t predicted use of CAM Healing therapy (physical action)
Adjusted for: age, education, CT, physical health
(Cameron, Booth et al. 2007)
Quasi experimental controlled trial / To examine the effectiveness of 12 weeks group intervention versus standard care to promoting adjustment in women with breast cancer. / Breast
2.61 (0.7) to 3.34 (0.7) years post-surgery
68-81% RT
29-52% CT
46-61% HT
35-48% Good prognosis
29-41% Average prognosis
NA
NA
NA / 154
72% of solicited
New Zealand
100% Women
48.3(8.5) to 54.6(8.9) years
91-96% White
44-55% Tertiary level
70%-86% Married
58000NZ$ - 765000NZ$
55-76% Employed / (1) dx of primary breast cancer within previous six weeks
(2) Undergoing adjuvant tx
(3) no evidence of psychopathology
(4) residence in Auckland region / Recruited at Auckland breast clinic between June 2000-March 2003
Three groups: a) 12-week intervention, b) decliner and, c) standard care
Patients completed self-reported questionnaires at baseline, 4, 6 and 12 months. / Cancer Worry Scale (CWSb)
Range: 0-20 / Intervention: ANOVA/ANCOVA
InterventionStandard care
Baseline8.71 (6.7)7.33 (6.4)
4-months4.99 (5.8)8.50(7.2) *
6-months5.60 (5.9)7.07 (6.6)
12-months6.33 (5.9)6.50 (6.3)
Intervention participant reported less FCR relative to standard care and decliner at 4 months. No overall changes from 6 and 12 months
(Cannon, Darrington et al. 2011)
Longitudinal / To examine prospectively the relationship between spirituality, patient-rated worry, and health-care utilization among cancer survivors with different malignancies. / Mixed: leukemia, lymphoma, multiple myeloma, breast, colon, prostate, lung, pancreatic
4.5 to 4.2 (0.5-26.6) years post-dx
30-32 % CT
45-46% CT+S+RT
23-24% Cell transplantation
NA
NA
NA
NA / 551
90% of solicited
USA
32-41% Women
59 (19-85) years
94-97% White
30-33% High school
78-81% Married
22-24% ≤$50,000
67-68% Employed / (1) 19 years
(2) completed tx at University of Nebraska Medical Center (UNMC) / Data obtained from CANCER CARE, an observational cohort study using a self-administered questionnaire
Survey forms were mailed in august 2008 (baseline), February 2009 (6-month follow-up) and August 2009 (12-month follow-up)
T1: Baseline
T2: 6 months
T3: 12 months / One item reported worry about “disease recurrence/progression”
Range: 1 (not at all) to 5 (all the time)
Response were categorized as low (1-2) vs high (3-5) worry / Functional Assessment of Cancer Therapy (FACT)-SP
Healthcare utilization
SF-12
Questions about social support and religiosity / Descriptive:
Baseline: 51% reported high FCR
Determinant: χ2
[-]Spirituality (High vs Low at baseline, 6 and 12-months) **
Predictors of FCR: Logistic Regression
[-] Spirituality (6 months: OR = 0.61, 95% CI = 0.42 - 0.89; 12 months: OR = 0.43, 95% CI 0.29 – 0.63)**
Consequence: Logistic Regression
FCR predicted
[+] Follow-up visits (6 months: OR = 1.81, 95% CI = 1.04 –3.12; 12 months: OR = 1.49, 95% CI = 1.00 –2.22)*
[+] Phone calls (6 months: OR = 2.21, 95% CI = 1.48–3.3, 12 months: (OR = 1.74, 95% CI = 1.20–2.53)**
[≠] Emergency room visits
[≠] Interaction between spirituality, worry and healthcare utilization
Adjusted: age, sex, cancer type, insurance, time since last tx
(Carpenter, Ganz et al. 2009)
Cross-sectional / To examine very long-term breast cancer survivors to determine whether CAM users had dissimilar patterns of association with survivorship factors. / Breast
13.2 years post-dx
30.4% BCT
69.6% RM
18.7% RT
19.6% CT
4.4% HT
13.8% In situ
56.1% Local
30.2% Distant
NA
66.9% Menopausal
83.3% Had comorbidities / 371
79.9% of solicited
USA
100% Women
46.6% < 49 years
53.4% ≥ 50 years
90.3% White
9.7% Hispanic
26.2% High school or less
NA
23.5% ≤ $45,000
NA / (1) long term survivors of breast cancer
(2) diagnosed at 40 years or younger / Follow-up interview with women participated in a population-based epidemiological study in young breast cancer in Los Angeles
Telephone interviews were conducted to gather information and complete assessments / Fear about Recurrence (FAR)
Range: 1 (strongly disagree) to 5 (strongly agree) / Alternative remedies list / Descriptive:
FCR score: 18.6 (NA)
Determinant:ANOVAs
[≠] CAM users (18.6) vs non-CAM users (18.5)
(Clark, Schover et al. 2001)
Cross-sectional / To analyse QoL and psychological adjustment after surgical therapy for localised renal cell carcinoma. / Renal
3.5 (1.1 – 7.5) years post-surgery
31% Elective partial
53% Mandatory partial
16% Radical
94% free of disease
NA
NA
NA / 97
75% of solicited
USA
26% Women
65.0 (33-84) years
NA
NA
NA
NA
NA / (1) localised cancer less than 4 cm in size
(2) underwent partial or radical nephrectomy between 1990 and 1997 / All eligible patients at the Cleveland Clinic Foundation were solicited by mail
Patients completed questionnaires and returned by mail / Single item: “Concern about cancer recurrence”
Range:NA / Descriptive:
FCR: 12.4% fairly or very often
Determinant: Multiple Logistic Regression
[-] Remaining amount of self-reported renal parenchyma* (remaining amount increases and FCR decreases)
[≠] Time since surgery, type of surgery, age, sex, marital status, race, education, complications of surgery, development of other disease, pain
(Costanzo, Lutgendorf et al. 2007)
Longitudinal / To evaluate the psychological adjustments of women 3 months post-tx for breast cancer. / Breast
NA
27.3% RM
79.5% BCS
71.6% CT
86.4% RT
77.0% HT
5.7% Stage 0
33.3% Stage I
47.1% Stage II
13.8% Stage III
NA
NA
NA / 89
90% of solicited
USA
100% Women
55.0 (32-89) years
93.2% Caucasian
2.3% African
31.8% High school or less
73.8% Married/partnered
32.9% ≤ $40,000
NA / (1) breast cancer stages 0 – III
(2) received adjuvant CT, RT or both
(3) no recurrent or metastasis cancer / Recruited in five tx centres in the Midwest