Lyhne Johanne Dam, Jensen Lars Henrik, Fink Per, Timm Signe, Frostholm Lisbeth, Smith Allan 'Ben'
Department of Oncology, Lillebaelt Hospital - Vejle, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
Department for Functional Disorders, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 11, Indgang A, Plan 9, A903, 8200, Aarhus N, Denmark.
J Cancer Surviv. 2025 Jan 27. doi: 10.1007/s11764-025-01746-z.
Knowledge about fear of cancer recurrence (FCR) among recurrence-free long-term colorectal cancer survivors (CRCS) is limited. This national cross-sectional study aimed to (1) assess the prevalence and correlates of FCR among CRCS; (2) investigate associations between colorectal cancer-specific symptoms and FCR; and (3) identify predictors of interest in engaging in FCR treatment.
We identified 9638 living Danish CRCS, age above 18 years, diagnosed between 2014 and 2018 through the Danish Clinical Registries. Electronic surveys were distributed between May 2023 and May 2024. FCR was measured on the Fear of Cancer Recurrence Inventory - Short Form (FCRI-SF). Associations with colorectal cancer-specific physical symptoms and psychological symptoms were analyzed using logistic regression models.
Of 5480 respondents (56.9%; mean age: 73, range (30-99; 42% female), 5.3% of survivors reported clinical FCR (cFCR). In multivariate analyses, having severe abdominal pain (OR 8.7 (95% CI 4.8-15.8)), abdominal bloating, tension, or heaviness (OR 10.0 (95% CI (6.1-16.3)) and tiredness (OR 7.1 (95% CI (4.1-12.1)) were associated with increased odds of cFCR, as were psychological symptoms (health anxiety; OR 19.7 (95% CI (13.5-28.6)), anxiety; OR 11.2 (95% CI (6.4-19.6)), depression; OR 5.5 (95% CI (2.6-11.9)) compared to no FCR. Among those with cFCR, 75% were interested in treatment, with higher interest among males and chemotherapy recipients.
FCR severity is strongly associated with specific colorectal symptoms, tiredness, and psychological symptoms.
Addressing cancer-specific physical symptoms may be a promising strategy for reducing FCR.
关于无复发长期结直肠癌幸存者（CRCS）对癌症复发恐惧（FCR）的了解有限。这项全国性横断面研究旨在：（1）评估CRCS中FCR的患病率及其相关因素；（2）调查结直肠癌特异性症状与FCR之间的关联；（3）确定对FCR治疗感兴趣的预测因素。
我们通过丹麦临床注册中心识别出9638名年龄在18岁以上、于2014年至2018年间被诊断出的在世丹麦CRCS。在2023年5月至2024年5月期间进行电子调查。FCR通过癌症复发恐惧量表简表（FCRI-SF）进行测量。使用逻辑回归模型分析与结直肠癌特异性身体症状和心理症状的关联。
在5480名受访者中（56.9%；平均年龄：73岁，范围为30 - 99岁；42%为女性），5.3%的幸存者报告有临床FCR（cFCR）。在多变量分析中，有严重腹痛（比值比[OR] 8.7（95%置信区间[CI] 4.8 - 15.8））、腹胀、紧张或沉重感（OR 10.0（95% CI（6.1 - 16.3））以及疲倦（OR 7.1（95% CI（4.1 - 12.1））与cFCR几率增加相关，心理症状（健康焦虑；OR 19.7（95% CI（13.5 - 28.6））、焦虑；OR 11.2（95% CI（6.4 - 19.6））、抑郁；OR 5.5（95% CI（2.6 - 11.9））与无FCR者相比也与cFCR几率增加相关。在有cFCR的患者中，75%对治疗感兴趣，男性和接受化疗者的兴趣更高。
FCR严重程度与特定的结直肠症状、疲倦和心理症状密切相关。
解决癌症特异性身体症状可能是降低FCR的一种有前景的策略。
