青年癌症幸存者对癌症复发的恐惧——在一个大型基于人群的队列中探索长期的促成因素。
Fear of cancer recurrence among young adult cancer survivors-exploring long-term contributing factors in a large, population-based cohort.
机构信息
National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
出版信息
J Cancer Surviv. 2021 Aug;15(4):497-508. doi: 10.1007/s11764-020-00943-2. Epub 2020 Sep 28.
PURPOSE
Fear of cancer recurrence (FCR) may be debilitating, yet knowledge of FCR among the growing population of long-term young adult cancer survivors (YACS) is scarce. We explored risk of FCR and associated factors in a nation-wide, population-based cohort of YACS.
METHODS
All 5-year survivors diagnosed at the ages of 19-39 years with breast cancer (BC), malignant melanoma (MM), colorectal cancer (CRC), leukemia (LEU), or non-Hodgkin lymphoma (NHL) between 1985 and 2009 in Norway were identified by the Cancer Registry of Norway and completed the cross-sectional comprehensive NOR-CAYACS health survey. Univariate and multivariate linear regression modeling was performed.
RESULTS
In total, 936 survivors were included, with an average of 16 years since diagnoses. BC was the most prevalent cancer form (38.4%), followed by MM (24.7%), NHL (15.6%), CRC (11.8%), and LEU (9.6%). Survivors worried most about getting another cancer (74%), and (20%) reported quite a bit or a lot of FCR. BC and MM survivors had the highest FCR scores. Post-traumatic stress symptoms (PTSS) had the strongest association with FCR (Std B 0.21, p < 0.01), above demographic and clinical variables.
CONCLUSIONS
FCR is prevalent even among long-term YACS, including survivors of MM with favorable prognoses.
IMPLICATIONS FOR CANCER SURVIVORS
Attention to ongoing risks of PTSS and FCR in this growing survivor population is warranted to optimize future survivorship care.
目的
对癌症复发的恐惧（FCR）可能使人衰弱，但在不断增加的长期青年成年癌症幸存者（YACS）人群中，对 FCR 的了解却很少。我们在一个全国性的基于人群的 YACS 队列中探讨了 FCR 的风险及其相关因素。
方法
所有在 1985 年至 2009 年间被诊断为 19-39 岁的乳腺癌（BC）、恶性黑色素瘤（MM）、结直肠癌（CRC）、白血病（LEU）或非霍奇金淋巴瘤（NHL）的 5 年幸存者均由挪威癌症登记处确定，并完成了横断面全面的 NOR-CAYACS 健康调查。进行了单变量和多变量线性回归建模。
结果
共纳入 936 名幸存者，平均诊断后时间为 16 年。BC 是最常见的癌症类型（38.4%），其次是 MM（24.7%）、NHL（15.6%）、CRC（11.8%）和 LEU（9.6%）。幸存者最担心再次患上癌症（74%），（20%）报告存在相当多或很多的 FCR。BC 和 MM 幸存者的 FCR 评分最高。创伤后应激症状（PTSS）与 FCR 的相关性最强（Std B 0.21，p < 0.01），高于人口统计学和临床变量。
结论
即使在长期 YACS 中，包括预后良好的 MM 幸存者，FCR 也很普遍。
对癌症幸存者的意义
在这个不断增加的幸存者群体中，需要关注持续存在的 PTSS 和 FCR 风险，以优化未来的生存护理。
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