Fear of Cancer Recurrence in Women with Gynecological Cancer: A Systematic Review

Although some types of gynecological cancer have a poor prognosis and high recurrence rate, less is known about the fear of cancer recurrence (FCR) in gynecological cancer patients than in other cancer populations. Psychosocial problems may be experienced more in gender-specific cancers. In order to prevent future health problems related to FCR, it is critical to identify the factors affecting FCR in different subgroups and to develop various interventions. The aim of this study was to review the literature on the factors affecting the FCR in women diagnosed with gynecological cancer and interventions to reduce the FCR. The protocol of this review was registered with PROSPERO (Registration number: CRD42023452570). A total of 18 studies from 10 different countries were included in the systematic review by searching on the PubMed, ScienceDirect, Ovid, Sage, Scopus, Taylor & Francis, Web of Science, CINAHL Complete, and Cochrane databases were searched in English between July-August 2023 without year limitation to identify studies on FCR in women with gynecological cancer. Data from eligible articles were extracted and appraised for quality by two independent reviewers. In addition, bibliometric analysis method was used to visually map the studies on FCR in women with gynecological cancer according to the most frequently repeated keyword, number of citations, most cited author and publication year. The findings of the study are categorized and interpreted under two headings, "Interventions affecting FCR" and "Factors influencing FCR". Sociodemographic characteristics such as age, economic status, social support, family history of cancer, psychological characteristics, quality of life and symptoms affect FCR. Deterioration in mental health and emotional weakness predict higher FCR, increase in positive emotional expression reduces FCR. The negative effects of cancer on sexuality and relationships, concerns about future treatments and emotional problems, and anxiety about not being able to fulfill their roles at home/work are the underlying reasons for the FCR. Therefore, professional psychosocial support should be provided to cancer survivors. Further studies are needed to identify the factors that trigger FCR and to plan interventions accordingly. This study is expected to encourage health professionals to plan interventions and research for gynecological cancer survivors.