Catzen Hannah Z, Abrahamse Paul, Ward Kevin C, Hawley Sarah T, Veenstra Christine M
University of Michigan, Ann Arbor, MI, USA.
Emory University, Atlanta, GA, USA.
Support Care Cancer. 2025 Jun 16;33(7):587. doi: 10.1007/s00520-025-09630-3.
Little is known about how colorectal (CRC) survivors and their partners communicate about cancer or experience fear of cancer recurrence (FCR). To effectively support and guide survivors and partners, we designed a dyadic survey and investigated whether survivors' health-related quality of life (HRQoL) was associated with dyadic discordance in communication or FCR.
From 2019-2020 we surveyed survivors of stage III CRC and their partners. We measured dyadic cancer communication using the Lewis Mutuality and Interpersonal Sensitivity Scale. We asked dyads 3 questions about FCR. We measured survivors' HrQoL using the PROMIS-29 + 2 profile, v 2.1. We used bivariate analyses and multivariable logistic regressions to compare survivor and partner responses, describe characteristics of discordant dyads, and assess associations between survivors' HrQoL and discordance in cancer communication and FCR.
We analyzed data from 307 paired survivor-partner dyads (51% survivor response rate; 73% partner response rate). 29% dyads were discordant in cancer communication. 26% dyads were discordant in FCR. Greater discordance in cancer communication was associated with female survivor sex and greater partner educational attainment. Greater discordance in FCR was associated with younger survivor age and receipt of radiation (all p < 0.05). Worse survivor HRQoL was associated with greater discordance in FCR and receipt of radiation (all p < 0.01).
Our findings highlight the complex dynamics dyads experience during CRC survivorship. While open communication is crucial, differing levels of shared fears and concerns can significantly impact health-related quality of life (HRQoL). Addressing these issues, especially FCR, can enhance patient-centered survivorship care.
关于结直肠癌（CRC）幸存者及其伴侣如何交流癌症相关事宜或体验癌症复发恐惧（FCR），我们所知甚少。为了有效支持和指导幸存者及其伴侣，我们设计了一项二元调查，并研究了幸存者的健康相关生活质量（HRQoL）是否与交流中的二元不一致或FCR相关。
在2019年至2020年期间，我们对III期CRC幸存者及其伴侣进行了调查。我们使用刘易斯相互性和人际敏感性量表来测量二元癌症交流情况。我们向二元组询问了3个关于FCR的问题。我们使用PROMIS-29 + 2简表（第2.1版）来测量幸存者的HRQoL。我们使用双变量分析和多变量逻辑回归来比较幸存者和伴侣的回答，描述不一致二元组的特征，并评估幸存者的HRQoL与癌症交流不一致和FCR之间的关联。
我们分析了来自307对幸存者-伴侣二元组的数据（幸存者回应率为51%；伴侣回应率为73%）。29%的二元组在癌症交流方面存在不一致。26%的二元组在FCR方面存在不一致。癌症交流中更大的不一致与女性幸存者性别和伴侣更高的教育程度相关。FCR中更大的不一致与幸存者更年轻的年龄和接受放疗相关（所有p < 0.05）。更差的幸存者HRQoL与FCR中更大的不一致和接受放疗相关（所有p < 0.01）。
我们的研究结果突出了二元组在CRC生存期间所经历的复杂动态。虽然开放的交流至关重要，但不同程度的共同恐惧和担忧会显著影响健康相关生活质量（HRQoL）。解决这些问题，尤其是FCR，可以加强以患者为中心的生存护理。
