Feasibility and Acceptability of the Fear-Less Screening and Stratified-Care Model for Fear of Cancer Recurrence Among People Affected by Early-Stage Cancer.

Abstract

Objectives: Fear of cancer recurrence (FCR) is a prevalent unmet need for people affected by cancer, in the context of limited healthcare resources. Stratified-care models have potential to meet this need, while reducing resource demands. This study aimed to evaluate the feasibility and acceptability of screening procedures and interventions within the Fear-Less stratified-care model among those impacted by early-stage cancer.

Methods: People affected by breast, head and neck, or gynaecological cancer, who had completed curative treatment, were screened for FCR. Individuals experiencing moderate FCR (scored 13-21 on the Fear of Cancer Recurrence Inventory-Short Form; FCRI-SF) were offered a purpose-developed clinician-guided self-management intervention, while those experiencing severe FCR (FCRI-SF score ≥ 22) were offered individual therapy (ConquerFear). Re-screening and evaluation measures were completed post-intervention.

Results: Seventy-six (70%) of 109 eligible people completed screening, with 53/76 participating in the Fear-Less model evaluation. Thirty-nine of 53 participants reported FCR and were referred to an intervention; 30/39 (77%) accepted the referral. Fifteen (83%) of 18 participants completing the self-management intervention reported reading ≥ 75% of the resource at 5 weeks, with 10/18 (56%) reporting clinically meaningful (≥ 10%) reductions on the FCRI-SF post-intervention. Qualitative feedback indicated screening and the stratified-care received were acceptable.

Conclusions: Screening procedures and interventions forming the Fear-Less model appear feasible and acceptable for identifying and treating FCR among people affected by early-stage cancer. Although further research is required to evaluate its efficacy, this model has the potential to meet a major unmet need, where psychosocial services are limited amid increased demand.

Trial registration: This study was retrospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622000818730) on 10/6/2022.