Fear of cancer recurrence and associated factors in Chinese patients with colorectal cancer: a cross-sectional study.

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Journal of gastrointestinal oncology Pub Date : 2025-08-30 Epub Date: 2025-08-26 DOI:10.21037/jgo-2025-503
Lijuan Xu, Wenli Dai, Li Chen, Lifeng Yao
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引用次数: 0

Abstract

Background: Colorectal cancer (CRC) is rising globally, with China bearing the highest burden. Fear of cancer recurrence (FCR) significantly impacts postoperative patients' well-being but remains understudied in China. The roles of illness perception, emotional distress, and social support in FCR are unclear. This study aims to assess FCR levels and identify influencing factors to guide early clinical intervention.

Methods: From November 2023 to May 2024, a cross-sectional survey was conducted among 314 postoperative CRC patients at a tertiary cancer hospital in Shanghai. Eligible adults (≥18 years) with confirmed CRC who had completed primary treatment were recruited via convenience sampling. Validated questionnaires were completed independently or with staff assistance. These included the Fear of Cancer Recurrence Inventory (FCRI), the Brief Illness Perception Questionnaire (BIPQ), the Social Support Rating Scale (SSRS), the 15-Item Social Constraints Scale (SCS-15), and the Hospital Anxiety and Depression Scale (HADS). Pearson correlation analysis was conducted to examine associations among FCR, illness perception, social factors, and psychological symptoms. Subsequently, multivariable logistic regression was conducted to identify independent predictors of high FCR.

Results: Of the 330 questionnaires distributed, 314 were deemed valid, yielding a response rate of 95.2%. The sample included 193 males (61.5%) and 121 females (38.5%), with a mean age of 59.7±12.3 years. Participants showed a high level of FCR, with a mean FCRI score of 69.64±27.10 and severity dimension score of 13.91±5.996. Univariate analysis revealed significant differences in age, monthly income, and residence between high and low-to-moderate FCR groups (P<0.05). The high FCR group had greater illness perception (BIPQ), higher social constraints (SCS-15), elevated anxiety and depression (P<0.001), and lower social support (SSRS; P=0.01) compared to the low-to-moderate group. Correlation analysis showed that FCR was significantly positively correlated with illness perception (r=0.548, P<0.01), social constraints (SCS-15; r=0.275, P<0.01), and psychological distress, including anxiety (r=0.596, P<0.01) and depression (r=0.426, P<0.01), highlighting the interplay among cognitive, social, and emotional factors. Subsequent binary logistic regression analysis identified illness perception and anxiety symptoms as significant independent predictors of FCR in patients with CRC.

Conclusions: FCR is common among postoperative CRC patients and is strongly linked to illness perception and anxiety. These findings underscore the need for routine psychological screening and tailored communication. Interventions addressing maladaptive beliefs and emotional distress, along with integrated psychoeducational and psychosocial support, may enhance resilience and improve quality of life in survivorship care.

中国结直肠癌患者对癌症复发的恐惧及其相关因素:一项横断面研究
背景:结直肠癌(CRC)在全球范围内呈上升趋势,其中中国负担最重。对癌症复发的恐惧(FCR)显著影响术后患者的幸福感,但在中国仍未得到充分研究。疾病知觉、情绪困扰和社会支持在FCR中的作用尚不清楚。本研究旨在评估FCR水平,识别影响因素,指导临床早期干预。方法:于2023年11月至2024年5月,对上海市某三级肿瘤医院314例结直肠癌术后患者进行横断面调查。通过方便抽样招募已完成初级治疗的确诊结直肠癌患者(≥18岁)。有效的问卷独立完成或在工作人员协助下完成。这些量表包括癌症复发恐惧量表(FCRI)、简短疾病感知问卷(BIPQ)、社会支持评定量表(SSRS)、15项社会约束量表(SCS-15)和医院焦虑抑郁量表(HADS)。采用Pearson相关分析检验FCR与疾病知觉、社会因素和心理症状之间的关系。随后,进行多变量逻辑回归,以确定高FCR的独立预测因素。结果:共发放问卷330份,有效问卷314份,回复率为95.2%。其中男性193例(61.5%),女性121例(38.5%),平均年龄59.7±12.3岁。受试者FCR水平较高,平均FCRI得分为69.64±27.10,严重性维度得分为13.91±5.996。单因素分析显示,FCR高组和低至中等FCR组在年龄、月收入和居住地方面存在显著差异。结论:FCR在结直肠癌术后患者中很常见,与疾病感知和焦虑密切相关。这些发现强调了常规心理筛查和量身定制沟通的必要性。针对适应不良信念和情绪困扰的干预措施,以及综合的心理教育和社会心理支持,可以增强幸存者护理的恢复力和改善生活质量。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
171
期刊介绍: ournal of Gastrointestinal Oncology (Print ISSN 2078-6891; Online ISSN 2219-679X; J Gastrointest Oncol; JGO), the official journal of Society for Gastrointestinal Oncology (SGO), is an open-access, international peer-reviewed journal. It is published quarterly (Sep. 2010- Dec. 2013), bimonthly (Feb. 2014 -) and openly distributed worldwide. JGO publishes manuscripts that focus on updated and practical information about diagnosis, prevention and clinical investigations of gastrointestinal cancer treatment. Specific areas of interest include, but not limited to, multimodality therapy, markers, imaging and tumor biology.
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