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Journal of cancer survivorship : research and practice
Dec 16, 2024;

Three-year trajectories and associated factors of fear of cancer recurrence in newly diagnosed head and neck cancer patients: a longitudinal study.

Eva Homan, Linda Kwakkenbos, Esther Deuning-Smit, Femke Jansen, Irma M Verdonck-de Leeuw, Robert P Takes, Johannes A Langendijk, C Ren�� Leemans, Remco de Bree, Jose A Hardillo, Femke Lamers, Judith B Prins, Jos�� A E Custers
Author Information
  1. Eva Homan: Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
  2. Linda Kwakkenbos: Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
  3. Esther Deuning-Smit: Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
  4. Femke Jansen: Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  5. Irma M Verdonck-de Leeuw: Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  6. Robert P Takes: Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
  7. Johannes A Langendijk: Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  8. C Ren�� Leemans: Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  9. Remco de Bree: Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
  10. Jose A Hardillo: Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  11. Femke Lamers: Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  12. Judith B Prins: Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
  13. Jos�� A E Custers: Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands. Jose.Custers@radboudumc.nl.
PMID: 39680304 DOI: 10.1007/s11764-024-01731-y

Abstract

PURPOSE: Limited data exists on the long-term course of fear of cancer recurrence (FCR) in head and neck cancer (HNC) patients. One in five patients was found to experience persistent high FCR in the first months after diagnosis. This study assessed the 3-year trajectories and associated factors of FCR in newly diagnosed HNC patients.
METHODS: Six hundred twenty-one patients from the NETherlands Quality of life and Biomedical Cohort study (NET-QUBIC) completed the FCR assessment at baseline, 3-, 6-, 12-, 24-, and 36-months posttreatment. Trajectories of FCR were identified using latent class growth analysis. Multinominal logistic regression analysis was used to assess associations between FCR trajectories and baseline demographic and medical variables, personality, and coping.
RESULTS: Three FCR trajectories were identified: "consistently high" (n���=���45, 7%), "elevated and declining" (n���=���209, 34%), and "low and declining" (n���=���367, 59%). Patients in the "elevated and declining" and "consistently high" trajectory were younger, had more comorbidities, higher negative adjustment, a higher level of neuroticism, more social support seeking, and more reliance on passive and palliative coping strategies.
CONCLUSION: Three years following diagnosis, the majority of HNC patients showed a resilient FCR trajectory whereas a small percentage of HNC patients (7%) showed persistent high FCR over time.
IMPLICATIONS FOR CANCER SURVIVORS: Younger patients and those with a higher level of neuroticism or maladaptive coping strategies were more vulnerable to have a consistent high level of FCR over time. It is important to identify these patients to provide optimal and tailored psychosocial support.

Keywords

Fear of cancer recurrence Head and neck cancer patients Latent class growth analysis Trajectories

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer J Clin. 2018;68(6):394���424. https://doi.org/10.3322/caac.21492 . [DOI: 10.3322/caac.21492]
  2. Rettig EM, D���Souza G. Epidemiology of head and neck cancer. Surg Oncol Clin. 2015;24(3):379���96. https://doi.org/10.1016/j.soc.2015.03.001 . [DOI: 10.1016/j.soc.2015.03.001]
  3. Mehanna H, Robinson M, Hartley A, Kong A, Foran B, Fulton-Lieuw T, ... Clark C. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial. The Lancet. 2019;393(10166), 51���60. https://doi.org/10.1016/S0140-6736(18)32752-1
  4. Deuning-Smit E, Custers JA, Miro��evi�� ��, Takes RP, Jansen F, Langendijk JA, Terhaard CH, Baatenburg de Jong RJ, Leemans CR, Smit JH, Kwakkenbos L, Verdonck-de Leeuw IM, Prins JB. Prospective longitudinal study on fear of cancer recurrence in patients newly diagnosed with head and neck cancer: course, trajectories, and associated factors. Head Neck. 2022;44(4):914���25. https://doi.org/10.1002/hed.26985 . [DOI: 10.1002/hed.26985]
  5. Mirosevic S, Thewes B, van Herpen C, Kaanders J, Merkx T, Humphris G, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Terhaard CHJ, Verdonck-de Leeuw IM, Takes R, Prins J. Prevalence and clinical and psychological correlates of high fear of cancer recurrence in patients newly diagnosed with head and neck cancer. Head Neck. 2019;41(9):3187���320. https://doi.org/10.1002/hed.25812 . [DOI: 10.1002/hed.25812]
  6. Lebel S, Ozakinci G, Humphris G, Mutsaers B, Thewes B, Prins J, Dinkel A, Butow P. From normal response to clinical problem: definition and clinical features of fear of cancer recurrence. Support Care Cancer. 2016;24(8):3265���8. https://doi.org/10.1007/s00520-016-3272-5 . [DOI: 10.1007/s00520-016-3272-5]
  7. Giuliani M, McQuestion M, Jones J, Papadakos J, Le LW, Alkazaz N, Cheng T, Waldron J, Catton P, Ringash J. Prevalence and nature of survivorship needs in patients with head and neck cancer. Head Neck. 2016;38(7):1097���103. https://doi.org/10.1002/hed.24411 . [DOI: 10.1002/hed.24411]
  8. Henry M, Habib LA, Morrison M, Yang JW, Li XJ, Lin S, Zeitouni A, Payne R, MacDonalds C, Mlynarek A, Kost K, Black M, Hier M. Head and neck cancer patients want us to support them psychologically in the posttreatment period: survey results. Palliat Support Care. 2014;12(6):481���93. https://doi.org/10.1017/S1478951513000771 . [DOI: 10.1017/S1478951513000771]
  9. Wells M, Cunningham M, Lang H, Swartzman S, Philp J, Taylor L, Thomson J. Distress, concerns and unmet needs in survivors of head and neck cancer: a cross-sectional survey. Eur J Cancer Care. 2015;24(5):748���60. https://doi.org/10.1111/ecc.12370 . [DOI: 10.1111/ecc.12370]
  10. Herschbach P, Dinkel A. Fear of progression. Psychooncology. 2013;197:11���29. https://doi.org/10.1007/978-3-642-40187-9_2 . [DOI: 10.1007/978-3-642-40187-9_2]
  11. Lee-Jones C, Humphris G, Dixon R, Bebbington Hatcher M. Fear of cancer recurrence ��� a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psychooncology. 1997;6(2):95���105. https://doi.org/10.1002/(SICI)1099-1611(199706)6:2%3c95::AID-PON250%3e3.0.CO;2-B . [DOI: 10.1002/(SICI)1099-1611(199706)6]
  12. Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, Ozakinci G. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Survivorship: Res Pract. 2013;7(3):300���22. https://doi.org/10.1007/s11764-013-0272-z . [DOI: 10.1007/s11764-013-0272-z]
  13. Leclair CS, Lebel S, Westmaas JL. The relationship between fear of cancer recurrence and health behaviors: a nationwide longitudinal study of cancer survivors. Health Psychol. 2019;38(7):596���605. https://doi.org/10.1037/hea0000754 . [DOI: 10.1037/hea0000754]
  14. Williams JT, Pearce A, Smith AB. A systematic review of fear of cancer recurrence related healthcare use and intervention cost-effectiveness. Psychooncology. 2021;30(8):1185���95. https://doi.org/10.1002/pon.5673 . [DOI: 10.1002/pon.5673]
  15. van Beek FE, Jansen F, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Smit JH, ... Verdonck-de Leeuw IM. Psychological problems among head and neck cancer patients in relation to utilization of healthcare and informal care and costs in the first two years after diagnosis. Current Oncology. 2022;29(5), 3200���3214. https://doi.org/10.3390/curroncol29050260
  16. Mutsaers B, Butow P, Dinkel A, Humphris G, Maheu C, Ozakinci G, Prins J, Sharpe L, Smith AB, Thewes B, Lebel S. Identifying the key characteristics of clinical fear of cancer recurrence: an international delphi study. Psychooncology. 2020;29(2):430���6. https://doi.org/10.1002/pon.5283 . [DOI: 10.1002/pon.5283]
  17. Tauber NM, O���Toole MS, Dinkel A, Galica J, Humphris G, Lebel S, Mahey C, Ozakinci G, Prins JB, Sharpe L, Smith AB, Thewes B, Simard S, Zachariae R. Effect of psychological intervention on fear of cancer recurrence: a systematic review and meta-analysis. J Clin Oncol. 2019;37(31):2899���915. https://doi.org/10.1200/jco.19.00572 . [DOI: 10.1200/jco.19.00572]
  18. Van de Wal M, Thewes B, Gielissen M, Speckens A, Prins J. Efficacy of blended cognitive behavior therapy for high fear of recurrence in breast, prostate, and colorectal cancer survivors: the SWORD study, a randomized controlled trial. J Clin Oncol. 2017;35(19):2173���83. https://doi.org/10.1200/jco.2016.70.5301 . [DOI: 10.1200/jco.2016.70.5301]
  19. Rogers SN, Monssen C, Humphris GM, Lowe D, Kanatas A. Which head and neck cancer patients are most at risk of high levels of fear of cancer recurrence. Front Psychol. 2021;12:671366. https://doi.org/10.3389/fpsyg.2021.671366 . [DOI: 10.3389/fpsyg.2021.671366]
  20. Chen LYU, Yan XU, Meng ZHOU, Lilu TIAN. Study on fear of recurrence and its influencing factors in patients with primary breast cancer. Tianjin J Nurs. 2021;29(3):259. https://doi.org/10.3969/j.issn.1006-9143.2021.03.002 . [DOI: 10.3969/j.issn.1006-9143.2021.03.002]
  21. Ng DW, Kwong A, Suen D, Chan M, Or A, Ng SS, Foo CC, Fielding BF, Lam WW. Fear of cancer recurrence among Chinese cancer survivors: prevalence and associations with metacognition and neuroticism. Psychooncology. 2019;28(6):1243���51. https://doi.org/10.1002/pon.5073 . [DOI: 10.1002/pon.5073]
  22. Zhang X, Sun D, Qin N, Liu M, Jiang N, Li X. Factors correlated with fear of cancer recurrence in cancer survivors: a meta-analysis. Cancer Nurs. 2022;45(5):406���15. https://doi.org/10.1097/NCC.0000000000001020 . [DOI: 10.1097/NCC.0000000000001020]
  23. Llewellyn CD, Weinman J, McGurk M, Humphris G. Can we predict which head and neck cancer survivors develop fears of recurrence? J Psychosom Res. 2008;65(6):525���32. https://doi.org/10.1016/j.jpsychores.2008.03.014 . [DOI: 10.1016/j.jpsychores.2008.03.014]
  24. Ghazali N, Cadwallader E, Lowe D, Humphris G, Ozakinci G, Rogers SN. Fear of recurrence among head and neck cancer survivors: longitudinal trends. Psychooncology. 2012;22(4):807���13. https://doi.org/10.1002/pon.3069 . [DOI: 10.1002/pon.3069]
  25. Koch L, Jansen L, Brenner H, Arndt V. Fear of recurrence and disease progression in long-term (���5 years) cancer survivors���a systematic review of quantitative studies. Psychooncology. 2013;22(1):1���11. https://doi.org/10.1002/pon.3022 . [DOI: 10.1002/pon.3022]
  26. Meissner VH, Olze L, Schiele S, Ankerst DP, Jahnen M, Gschwend JE, Herkommer K, Dinkel A. Fear of cancer recurrence and disease progression in long-term prostate cancer survivors after radical prostatectomy: a longitudinal study. Cancer. 2021;127(22):4287���95. https://doi.org/10.1002/cncr.33836 . [DOI: 10.1002/cncr.33836]
  27. Savard J, Ivers H. The evolution of fear of cancer recurrence during the cancer care trajectory and its relationship with cancer characteristics. J Psychosom Res. 2013;74(4):354���60. https://doi.org/10.1016/j.jpsychores.2012.12.013 . [DOI: 10.1016/j.jpsychores.2012.12.013]
  28. Deuning-Smit E, Kolsteren EE, Kwakkenbos L, Custers JA, Hermens RP, Prins JB. Barriers and facilitators for implementation of the SWORD evidence-based psychological intervention for fear of cancer recurrence in three different healthcare settings. J Cancer Surviv. 2022;17(4):1057���71. https://doi.org/10.1007/s11764-022-01285-x . [DOI: 10.1007/s11764-022-01285-x]
  29. Prins JB, Deuning-Smit E, Custers JA. Interventions addressing fear of cancer recurrence: challenges and future perspectives. Curr Opin Oncol. 2022;34(4):279���84. https://doi.org/10.1097/CCO.0000000000000837 . [DOI: 10.1097/CCO.0000000000000837]
  30. Custers JA, Kwakkenbos L, Van de Wal M, Prins JB, Thewes B. Re-validation and screening capacity of the 6-item version of the cancer worry scale. Psychooncology. 2018;27(11):2609���15. https://doi.org/10.1002/pon.4782 . [DOI: 10.1002/pon.4782]
  31. Paleri V, Wight RG. Applicability of the adult comorbidity evaluation���27 and the Charlson indexes to assess comorbidity by notes extraction in a cohort of United Kingdom patients with head and neck cancer: a retrospective study. J Laryngol Otol. 2002;116(3):200���5. https://doi.org/10.1258/0022215021910528 . [DOI: 10.1258/0022215021910528]
  32. Braeken AP, Kempen GI, Watson M, Houben RM, Gils FC, Lechner L. Psychometric properties of the Dutch version of the mental adjustment to cancer scale in Dutch cancer patients. Psychooncology. 2009;19(7):742���9. https://doi.org/10.1002/pon.1628 . [DOI: 10.1002/pon.1628]
  33. Watson M, Greer S, Young J, Inayat Q, Burgess C, Robertson B. Development of a questionnaire measure of adjustment to cancer: the MAC scale. Psychol Med. 1988;18(1):203���9. https://doi.org/10.1017/S0033291700002026 . [DOI: 10.1017/S0033291700002026]
  34. Schreurs PJ, Tellegen B, Willige GV. Gezondheid, stress en coping: de ontwikkeling van de Utrechtse coping-lijst [Health, stress and coping: the development of the Utrecht coping list]. Gedrag: tijdschrift voor psychologie. 1984;12(1���2), 101���117. https://psycnet.apa.org/record/1985-08432-001
  35. Schreurs PJG, Willige GVD, Brosschot HF, Tellegen B, Graus GMH. Handleiding Utrechtse Coping Lijst UCL [UCL Utrecht Coping List Manual]. Lisse: Swets & Zeitlinger; 1993.
  36. Schwarzer R, Jerusalem M. Generalized self-efficacy scale. In: Weinman J, Wright S, Johnston M, editors. Measures in health psychology: a user���s portfolio. Winsor, UK: NFER-NELSON; 1995. pp. 35���37. https://doi.org/10.1037/t00393-000 .
  37. Costa PT, McCrae RR. Revised NEO personality inventory (NEO PI-R) and NEO five-factor inventory (NEO-FFI). Psychological Assesment Resources. 1992
  38. Egberink IJL, de Leng WE, Vermeulen CSM (2023, january 2nd). COTAN beoordeling 1999, NEO FFI Five Factor Inventory [COTAN review 1999, NEO FFI Five Factor Inventory]. Retrieved from www.cotandocumentatie.nl
  39. Schwarzer R 2014. Everything you wanted to know about the General Self-Efficacy Scale but were afraid to ask. Documentation of the General Self-Efficacy Scale. Retrieved April 15, 2023, from https://userpage.fu-berlin.de/~health/faq_gse.pdf
  40. Jung T, Wickrama KA. An introduction to latent class growth analysis and growth mixture modeling. Soc Pers Psychol Compass. 2007;2(1):302���17. https://doi.org/10.1111/j.1751-9004.2007.00054.x . [DOI: 10.1111/j.1751-9004.2007.00054.x]
  41. Vatcheva KP, Lee M, McCormick JB, Rahbar MH. Multicollinearity in regression analyses conducted in epidemiologic studies. Epidemiology. 2016;6(2):227. https://doi.org/10.4172/2161-1165.1000227 . [DOI: 10.4172/2161-1165.1000227]
  42. Smith A, Dunn KM. Research Note: deriving latent trajectories in health research. J Physiother. 2023;69(1):61���4. https://doi.org/10.1016/j.jphys.2022.11.001 . [DOI: 10.1016/j.jphys.2022.11.001]
  43. Jansen F, Brakenhoff RH, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Takes RP, Terhaard CHJ, Smit JH, Verdonck-de Leeuw IM. Study retention and attrition in a longitudinal cohort study including patient-reported outcomes, fieldwork and biobank samples: results of the Netherlands quality of life and Biomedical cohort study (NET-QUBIC) among 739 head and neck cancer patients and 262 informal caregivers. BMC Med Res Methodol. 2022;22(1):27. https://doi.org/10.1186/s12874-022-01514-y . [DOI: 10.1186/s12874-022-01514-y]
  44. Custers JA, Kwakkenbos L, Van der Graaf WT, Prins JB, Gielissen MF, Thewes B. Not as stable as we think: a descriptive study of 12 monthly assessments of fear of cancer recurrence among curatively-treated breast cancer survivors 0���5 years after surgery. Front Psychol. 2020;11:580979. https://doi.org/10.3389/fpsyg.2020.580979 . [DOI: 10.3389/fpsyg.2020.580979]
  45. Shim EJ, Jeong D, Lee SB, Min YH. Trajectory of fear of cancer recurrence and beliefs and rates of medication adherence in patients with breast cancer. Psychooncology. 2020;29(11):1835���41. https://doi.org/10.1002/pon.5497 . [DOI: 10.1002/pon.5497]
  46. Schapira L, Zheng Y, Gelber SI, Poorvu P, Ruddy KJ, Tamimi RM, Peppercorn J, Come SE, Borges VF, Partridge AH, Rosenberg SM. Trajectories of fear of cancer recurrence in young breast cancer survivors. Cancer. 2022;128(2):335���43. https://doi.org/10.1002/cncr.33921 . [DOI: 10.1002/cncr.33921]
  47. Guo H, Wang S, Zhang C, Zhang H, Wei M, Wu Y, et al. Investigation of factors influencing the fear of cancer recurrence in breast cancer patients using structural equation modeling: a cross-sectional study. Int J Clin Pract. 2022;2022:279408.  https://doi.org/10.1155/2022/2794408 .
  48. Zheng W, Hu M, Liu Y. Social support can alleviate the fear of cancer recurrence in postoperative patients with lung carcinoma. American journal of translational research. 2022;14(7), 4804���4811. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360850/
  49. Lahey BB. Public health significance of neuroticism. Am Psychol. 2009;64(4):241���56. https://doi.org/10.1037/a0015309 . [DOI: 10.1037/a0015309]
  50. Melchior H, B��scher C, Thorenz A, Grochocka A, Koch U, Watzke B. Self-efficacy and fear of cancer progression during the year following diagnosis of breast cancer. Psychooncology. 2011;22(1):39���45. https://doi.org/10.1002/pon.2054 . [DOI: 10.1002/pon.2054]
  51. Jansen F, Lissenberg-Witte BI, Krebber AM, Cuijpers P, De Bree R, Becker-Commissaris A, Smit EF, Van Straten A, Eeckhout GM, Beekman AT, Leemans CR, Verdonck-de Leeuw IM. Stepped care targeting psychological distress in head and neck cancer and lung cancer patients: which groups specifically benefit? Secondary analyses of a randomized controlled trial. Support Care Cancer. 2019;27(12):4543���53. https://doi.org/10.1007/s00520-019-04714-3 . [DOI: 10.1007/s00520-019-04714-3]
  52. Verdonck-de Leeuw I, Jansen F, Brakenhoff RH, Langendijk JA, Takes R, Terhaard CH, Baatenburg de Jong RJ, Smit JH, Leemans CR. Advancing interdisciplinary research in head and neck cancer through a multicenter longitudinal prospective cohort study: the Netherlands quality of life and biomedical cohort (NET-QUBIC) data warehouse and biobank. BMC Cancer. 2019;19(1):1���13. https://doi.org/10.1186/s12885-019-5866-z . [DOI: 10.1186/s12885-019-5866-z]
Journal Article

Word Cloud

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