Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100000, China.
J Psychosom Res. 2023 Mar;166:111177. doi: 10.1016/j.jpsychores.2023.111177. Epub 2023 Feb 2.
Fear of cancer recurrence (FCR) is one of the most common and aversive psychological phenomena among cancer patients. This study explored the trajectories of FCR over the 18 months following discharge, and evaluated the associations between baseline demographic and clinical variables and FCR trajectories among Chinese women treated for breast cancer.
This is a longitudinal prospective study. All participants were asked to completed a battery of questionnaires (FCR-7, PHQ-9, GAD-7 and MPQ-VAS) at baseline, 6, 12, and 18 months after discharge. Generalized linear mixed model and group-based trajectory analyses were conducted.
Three hundred women with breast cancer were recruited. Latent class growth modeling analysis showed that three-group trajectory solution was the best fitting (i.e., 'intermediate level-stable group' (63.3%), 'low level-increasing group' (18.3%), and 'high level-decreasing group' (18.3%). Patients reported significant higher FCR at baseline assessment compared to other time points. Significant positive associations were found between anxiety, depression and FCR. Patients who had no baseline depression (estimate = -2.14, 95% CI: -2.78-(-1.51), P < 0.001) or anxiety (estimate = -2.77, 95% CI: -3.44-(-2.10), P < 0.001) tended to report significant lower FCRs over time. Women with none/mild life stress exhibited significant lower FCRs than those with moderate/high life stress, and participants with a family history of cancer or pessimism reported higher FCRs.
60% of the breast cancer women showed intermediate level-stable FCRs over the 18 months after discharge. Baseline anxiety, depression, life stress, family cancer history and pessimism predicts higher FCR levels. Clinical teams responsible for continuing patient care following treatment should develop clearer strategies for management of FCR.
癌症复发恐惧（FCR）是癌症患者中最常见和最令人厌恶的心理现象之一。本研究探讨了癌症患者出院后 18 个月内 FCR 的变化轨迹，并评估了基线人口统计学和临床变量与中国乳腺癌患者 FCR 轨迹之间的关系。
这是一项纵向前瞻性研究。所有参与者在出院后 6、12 和 18 个月时被要求完成一系列问卷（FCR-7、PHQ-9、GAD-7 和 MPQ-VAS）。进行了广义线性混合模型和基于群组的轨迹分析。
共招募了 300 名乳腺癌患者。潜在类别增长模型分析显示，三组轨迹解决方案是最佳拟合（即“中等水平稳定组”（63.3%）、“低水平增加组”（18.3%）和“高水平下降组”（18.3%）。患者在基线评估时报告的 FCR 显著高于其他时间点。焦虑和抑郁与 FCR 呈显著正相关。无基线抑郁的患者（估计值=-2.14，95%CI：-2.78-（-1.51），P<0.001）或焦虑（估计值=-2.77，95%CI：-3.44-（-2.10），P<0.001）倾向于随着时间的推移报告 FCR 显著降低。无/轻度生活压力的女性 FCR 显著低于中度/高度生活压力的女性，有癌症家族史或悲观主义的参与者报告的 FCR 较高。
60%的乳腺癌女性在出院后 18 个月内表现出中等水平稳定的 FCR。基线焦虑、抑郁、生活压力、家族癌症史和悲观主义预测更高的 FCR 水平。负责治疗后继续患者护理的临床团队应制定更明确的 FCR 管理策略。
