Patel Diya S, Webster Sarah N, Dowling Emily J, Knowles Claudia R, Lockwood-Taylor Georgina, Coutts-Bain Daelin, Simons Laura E, Diver Elisabeth J, Chilcot Joseph, Schapira Lidia, Heathcote Lauren C
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Department of Psychology, University of Miami, Miami, Florida, USA.
Psychooncology. 2024 Dec;33(12):e70050. doi: 10.1002/pon.70050.
Adolescent and young adult (AYA) females are vulnerable to psychological sequelae following cancer diagnosis and treatment. Fear of cancer recurrence (FCR) is well-documented in cancer survivors, however AYA survivors of breast and gynaecological cancers are less well-studied. Moreover, little is known about scan-related fears and anxiety ('scanxiety') in survivors of any age group.
This study aimed to assess demographic, medical, and quality-of-life correlates of FCR and scanxiety in AYA female breast and gynaecological cancer survivors post-treatment. Additionally, we explored potential shared mechanisms of FCR and scanxiety, including intolerance of uncertainty, bodily threat monitoring, and perceived stress.
AYA breast and gynaecological cancer survivors (N = 115) completed measures of FCR, scanxiety, intolerance of uncertainty, bodily threat monitoring, perceived stress, and quality of life. Bivariate associations and a structural equation model explored relationships between these variables.
Both FCR and scanxiety were prevalent, with 84% reporting clinically meaningful FCR and 38% reporting severe FCR. Higher FCR and scanxiety were both associated with poorer quality of life. FCR and scanxiety were moderately associated but not entirely overlapping. Intolerance of uncertainty, bodily threat monitoring, and perceived stress were significantly correlated with both FCR and scanxiety. The structural equation model indicated that bodily threat monitoring is a plausible intermediate variable linking intolerance of uncertainty and FCR, but not scanxiety.
FCR and scanxiety are common in AYA survivors of breast and gynaecological cancers, with potentially distinct underlying mechanisms. Interventions targeting intolerance of uncertainty and bodily threat monitoring may reduce FCR, while further research is needed to identify therapeutic targets for scanxiety.
青少年及年轻成年（AYA）女性在癌症诊断和治疗后易出现心理后遗症。癌症幸存者中对癌症复发的恐惧（FCR）已有充分记录，然而乳腺癌和妇科癌症的AYA幸存者的相关研究较少。此外，对于任何年龄组的幸存者中与扫描相关的恐惧和焦虑（“扫描焦虑症”）知之甚少。
本研究旨在评估治疗后AYA女性乳腺癌和妇科癌症幸存者中FCR和扫描焦虑症的人口统计学、医学及生活质量相关因素。此外，我们探讨了FCR和扫描焦虑症潜在的共同机制，包括对不确定性的不耐受、身体威胁监测和感知压力。
AYA乳腺癌和妇科癌症幸存者（N = 115）完成了FCR、扫描焦虑症、对不确定性的不耐受、身体威胁监测、感知压力及生活质量的测量。双变量关联和结构方程模型探讨了这些变量之间的关系。
FCR和扫描焦虑症都很普遍，84%的人报告有临床意义的FCR，38%的人报告有严重FCR。较高的FCR和扫描焦虑症均与较差的生活质量相关。FCR和扫描焦虑症中度相关但并非完全重叠。对不确定性的不耐受、身体威胁监测和感知压力与FCR和扫描焦虑症均显著相关。结构方程模型表明，身体威胁监测是连接对不确定性的不耐受和FCR而非扫描焦虑症的一个合理中间变量。
FCR和扫描焦虑症在AYA乳腺癌和妇科癌症幸存者中很常见，且可能有不同的潜在机制。针对对不确定性的不耐受和身体威胁监测的干预措施可能会降低FCR，而需要进一步研究以确定扫描焦虑症的治疗靶点。
