Chen Ziyi, Ni Ping, Wu Bei, Ko Eunjeong, Liao Jing, Lin Huijing, Ma Peiying
School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Rory Meyers College of Nursing and NYU Aging Incubator, New York University, New York, NY, USA.
J Cancer Surviv. 2025 Apr 22. doi: 10.1007/s11764-025-01812-6.
Fear of cancer recurrence (FCR) is common and burdensome in adolescent and young adult (AYA) cancer survivors. This systematic review examines FCR assessment, prevalence, severity, progression, related factors, consequences, and interventions in AYA cancer survivors.
Electronic databases including PubMed, CINAHL, PsycINFO, Cochrane, and Embase were searched from their inception to October 2024. Two reviewers identified eligible peer-reviewed empirical studies, including both qualitative and quantitative ones on FCR in AYA survivors. The risk of bias was assessed using the Mixed-Methods Appraisal Tool. Quantitative studies were synthesized narratively, while qualitative studies underwent thematic synthesis.
Among the 5340 studies identified, 34 studies were included finally. 21.4 to 93.3% of AYA cancer survivors experienced FCR. About one-third of survivors with moderate or high FCR improved over time. Female survivors, those with advanced cancer stages, and individuals with negative illness perceptions or higher anxiety reported higher FCR. Persistent FCR was associated with increased psychological problems and lower quality of life. Two studies on behavioral interventions, particularly internet-based cognitive-behavioral therapy (CBT), were acceptable but had limited evidence of efficacy.
FCR is prevalent among AYA cancer survivors, particularly in female survivors, those with advanced cancer stages, and those with negative perceptions or higher anxiety. A significant proportion experience persistent, but variability in current evidence limits a comprehensive understanding of its severity, progression, and intervention efficacy. To enhance FCR management, the use of validated assessment tools is essential in both research and clinical contexts. Addressing the physical and psychological aspects of survivorship through comprehensive care is crucial for alleviating FCR and improving overall well-being.
Identifying the key factors of FCR will stimulate the research and the development of targeted interventions for AYA cancer survivors.
癌症复发恐惧（FCR）在青少年和青年成年（AYA）癌症幸存者中很常见且负担沉重。本系统评价考察了AYA癌症幸存者的FCR评估、患病率、严重程度、进展、相关因素、后果及干预措施。
检索了包括PubMed、CINAHL、PsycINFO、Cochrane和Embase在内的电子数据库，检索时间从建库至2024年10月。两名评审员确定了符合条件的同行评审实证研究，包括关于AYA幸存者FCR的定性和定量研究。使用混合方法评估工具评估偏倚风险。定量研究进行叙述性综合，定性研究进行主题综合。
在识别出的5340项研究中，最终纳入34项研究。21.4%至93.3%的AYA癌症幸存者经历过FCR。约三分之一FCR为中度或高度的幸存者随时间推移有所改善。女性幸存者、癌症晚期患者以及疾病认知消极或焦虑程度较高的个体报告的FCR更高。持续性FCR与心理问题增加和生活质量降低相关。两项关于行为干预的研究，特别是基于互联网的认知行为疗法（CBT），是可接受的，但疗效证据有限。
FCR在AYA癌症幸存者中普遍存在，尤其是女性幸存者、癌症晚期患者以及认知消极或焦虑程度较高的患者。相当一部分人经历持续性FCR，但目前证据的变异性限制了对其严重程度、进展和干预疗效的全面理解。为加强FCR管理，在研究和临床环境中使用经过验证的评估工具至关重要。通过全面护理解决幸存者的身体和心理问题对于减轻FCR和改善整体幸福感至关重要。
确定FCR的关键因素将推动针对AYA癌症幸存者的针对性干预措施的研究和开发。
