Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong.
Department of Surgery, The University of Hong Kong, Hong Kong.
Psychooncology. 2019 Jun;28(6):1243-1251. doi: 10.1002/pon.5073. Epub 2019 Apr 26.
Fear of cancer recurrence (FCR) represents a chronic burden for many cancer survivors. We determined FCR prevalence and potential correlates, specifically metacognitive styles and neuroticism among Chinese cancer survivors with breast or colorectal cancer.
This study included 285 Chinese patients with breast (N = 173) and colorectal (N = 112) cancers at 8-week postsurgery. Participants completed a set of baseline questionnaires evaluating FCR (Fear of Cancer Recurrence Inventory-Short Form [FCRI-SF]), metacognition (Metacognitions Questionnaire-30), and neuroticism (Eysenck Personality Questionnaire). Scores of 13 to 21 were indicative of subclinical FCR on the FCRI-SF. Scores greater than or equal to 22 indicated clinically significant levels of FCR. Fully adjusted multinomial logistic regressions identified correlates of subclinical and clinically significant FCR.
Respectively, 26.0% (n = 74) and 11.2% (n = 32) achieved scores indicating subclinical and clinically significant FCR. Expressing significantly more positive (OR = 1.21, P = .003) and negative (OR = 1.19, P = .005) beliefs about worry was associated with a higher likelihood of reporting subclinical FCR. Both higher neuroticism (OR = 1.28, P = .003) and more negative beliefs about worry (OR = 1.19, P = 0.035) were associated with an increased likelihood of experiencing clinically significant FCR.
Positive and negative metacognitions may play an important role in the development of subclinical FCR. In particular, negative metacognition and neuroticism may elevate FCR from subclinical to a clinical level. The findings give insight into the identification of cancer survivors with subclinical or clinical FCR and aid the development of interventions aimed at changing metacognitive beliefs in order to manage FCR.
癌症复发恐惧（FCR）是许多癌症幸存者的长期负担。我们确定了中国乳腺癌和结直肠癌幸存者的 FCR 患病率和潜在相关因素，特别是元认知风格和神经质。
本研究包括 285 名术后 8 周的中国乳腺癌（N=173）和结直肠癌（N=112）患者。参与者完成了一组基线问卷，评估 FCR（癌症复发恐惧量表-短表[FCRI-SF]）、元认知（元认知问卷-30）和神经质（艾森克人格问卷）。FCRI-SF 得分为 13-21 分提示亚临床 FCR。得分≥22 分提示临床显著水平的 FCR。完全调整的多项逻辑回归确定了亚临床和临床显著 FCR 的相关因素。
分别有 26.0%（n=74）和 11.2%（n=32）的患者得分提示亚临床和临床显著的 FCR。表达更多关于担忧的积极（OR=1.21，P=.003）和消极（OR=1.19，P=.005）信念与报告亚临床 FCR 的可能性更高相关。神经质水平较高（OR=1.28，P=.003）和对担忧的消极信念更多（OR=1.19，P=.035）与临床显著 FCR 的可能性增加相关。
积极和消极的元认知在亚临床 FCR 的发展中可能起着重要作用。特别是，消极的元认知和神经质可能会将 FCR 从亚临床水平提升到临床水平。这些发现深入了解了亚临床或临床 FCR 癌症幸存者的识别，并有助于开发旨在改变元认知信念以管理 FCR 的干预措施。
