Fear of recurrence, secondary cancers, and health problems in long-term survivors of childhood cancer: Findings from a Canadian cohort.

INTRODUCTION: Survivors of childhood cancer are at lifelong risk for health problems, secondary cancers, and recurrence. However, little is known about their fears related to these risks nor the factors associated with them.

METHODS: A Canadian cohort of childhood cancer survivors (n = 284; 51.1% male; mean age = 22.3 years, mean time off treatment = 12.4 years) reported on their fears of health problems, secondary cancers, and recurrence; physical functioning; psychosocial symptoms; and substance use. The relationship between their fears and various demographic, physical, and psychosocial variables was assessed through multivariate logistic regression analyses.

RESULTS: Thirty-seven percent of survivors reported at least one cancer fear. Fear of secondary cancer was the most reported (25.0%), followed by fear of future health problems (24.6%) and fear of recurrence (21.8%). Survivors who reported having ever drunk to intoxication were more likely to report all three cancer fears (ps < .01-<.05) and those who endorsed ever using marijuana/cannabis were more likely to report fear of health problems or secondary cancer (ps = <.01-.05). At the multivariate level, various demographic characteristics (e.g., female sex), physical (e.g., health problems), and psychosocial factors (e.g., anxiety) were associated with the presence of fears.

CONCLUSION: More than one third of long-term survivors of childhood cancer endorse fears related to their risk of health problems, secondary cancers, and/or recurrence, which is associated with physical and psychosocial functioning and substance use. Multimodal interventions targeting cancer fears in long-term survivors of childhood cancer are needed to promote adaptive coping throughout survivorship.