Cognitive and emotional aspects of fear of recurrence: predictors and relations with adjustment in young to middle-aged cancer survivors

Objective: We investigated predictors of emotional (worry) and cognitive (perceived risk) dimensions of fear of recurrence (FOR) and their relationships with psychological well-being in a sample of young and middle-aged adult cancer survivors. Methods: Eligible participants were survivors between 18 and 55years old and diagnosed from 1 to 3years prior. A total of 250 participants were recruited, and 167 responded to a 1-year follow-up. Demographic and psychosocial variables were assessed at baseline, and FOR and psychological well-being were assessed at follow-up. Results: Race was associated with the cognitive dimension of FOR (such that minority race perceived less risk of recurrence), but no demographics were associated with the emotional dimension. Hierarchical regression analyses showed that spirituality was the only predictor of perceived risk independent of the effect of race, even when worry about general health was controlled. For the emotional dimension of FOR, avoidance coping predicted higher worry, but when controlling for a general tendency to worry about one's health, none of the psychosocial variables predicted worries about cancer's return. In addition, only worry about cancer's return predicted negative affect and intrusive thoughts. Conclusions: These results suggest that FOR comprises distinct dimensions, each of which has different implications for adjustment. These findings may have important clinical implications in developing interventions to deal with both FOR and more general health anxieties in cancer survivors. Copyright (c) 2012 John Wiley & Sons, Ltd.