Toward a Better Understanding of Fear of Cancer Recurrence in Adolescents and Young Adults: Validation of a Theoretical Model

Abstract

Purpose:

Theoretical models on fear of cancer recurrence (FCR) have been developed and validated for adult cancer survivors, despite high levels of FCR being found in adolescents and young adults (AYAs). This study intended to empirically validate a model of FCR for AYAs based on the theoretical models of Lee-Jones and Lebel.

Methods:

One hundred AYAs diagnosed with cancer between the ages of 15 and 25 were included (59% female). Data were collected online and in-person from four hospitals and one association for young cancer patients in Portugal using the Quality of Life (QoL) Questionnaire Core-30, the FCR7 scale, the Emotion Regulation Questionnaire, the 15-item Systematic Clinical Outcome and Routine Evaluation scale, the Satisfaction with Social Support Scale, and the Hospital Anxiety and Depression Scale.

Results:

A path analysis showed an excellent model fit: χ²(28) = 30, p = 0.363; Bentler comparative fit index (CFI) = 0.99; Tucker–Lewis index = 0.98; root-mean-square error of approximation = 0.03; standardized root-mean-square residual = 0.08. Significant paths were found from FCR to depressive symptoms and QoL, with friends’ support moderating the path between FCR and depressive symptoms. Depressive symptoms and QoL were also related to emotion suppression and friends’ support.

Conclusion:

Being satisfied with their friends’ support seems to be protective for AYAs with high FCR levels, while satisfaction with family support does not seem to have an influence. This diverges from previous models, supporting the need for a distinct AYA model. Additionally, emotion suppression was related to depression and QoL, but not FCR.