The fear of cancer recurrence in elderly patients after endoscopic submucosal dissection for early esophageal cancer: a cross-sectional study.

BACKGROUND

After endoscopic submucosal dissection (ESD) for early esophageal cancer, elderly patients generally have a fear of cancer recurrence (FCR), which may affect the effectiveness of treatment and the quality of life of patients. This study sought to investigate the FCR in elderly patients after ESD for early esophageal cancer and to analyze the factors associated with this fear.

METHODS

Elderly patients with early esophageal cancer who underwent ESD at a general hospital in Nanjing, Jiangsu Province, were enrolled in this study. Survivors were evaluated using measures of FCR [Fear of Progression Questionnaire-Short Form (FoP-Q-SF)], disease perception (Brief Illness Perception Questionnaire), and coping styles (Medical Coping Modes Questionnaire) one month after surgery. Multivariate stepwise linear analysis is carried out.

RESULTS

A total of 162 patients participated in the study. The total FoP-Q-SF score of the elderly patients after ESD for early esophageal cancer was 34.38±4.1, the physical health dimension score was 19.96±2.78, and the social-family dimension score was 14.40±2.23, which exceeded the average level (≥34) in 98 cases (60.5%). The multiple stepwise regression analysis showed that literacy (β=-0.132, P=0.02), esophageal stenosis (β=0.132, P=0.02), the disease perception score (β=0.385, P<0.001), and the resignation dimension score (β=0.469, P<0.001) were the main factors influencing the FCR in elderly patients after ESD for early esophageal cancer.

CONCLUSIONS

The FCR is high in elderly patients after ESD for early esophageal cancer. Healthcare professionals should implement personalized disease-related health education programs to help patients reduce their fear of the disease, guide patients to adopt positive and effective coping styles, and improve the confidence and ability of patients to deal with disease-related problems to reduce the level of FCR.