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Published in: Journal of Cancer Survivorship 4/2015

01-12-2015

Anxiety and fear of cancer recurrence and its association with supportive care needs and health-care service utilization in cancer patients

Authors: Susanne Sarkar, Leon Sautier, Georgia Schilling, Carsten Bokemeyer, Uwe Koch, Anja Mehnert

Published in: Journal of Cancer Survivorship | Issue 4/2015

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Abstract

Purpose and methods

We investigated the relationship between fear of cancer recurrence (FCR), anxiety, supportive care needs, and utilization of health-care services in a mixed sample of 335 cancer patients. We used validated questionnaires including the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the General Anxiety Disorder Scale (GAD-7) and the Supportive Care Needs Survey (SCNS-SF34). Health-care services utilization was measured by a self-constructed questionnaire recording the use of 22 health and supportive care offers.

Results

In our sample, 3.9 % of patients were classified as having high anxiety and 5.1 % had high FCR. Patients reported the highest unmet supportive care needs in the domain health system and information followed by psychological needs. Integrated care and complementary support services were the most frequently used (32 %) followed by medical (31 %), psychological (23 %), spiritual and religious (8 %) and other support services (9 %). Whereas anxiety was related to both unmet psychological and physical/daily living needs (p < 0.01), FCR was associated with unmet supportive care needs in all five domains further including needs with regard to health system and information, patient care, and sexuality (p < 0.01). However, higher levels of anxiety and FCR were not related to higher utilization of health-care services.

Conclusion

Our findings show that FCR plays a significant role in unmet supportive care needs in cancer patients but not for health-care service utilization.

Implications for Cancer Survivors

We recommend that clinicians monitor supportive care needs in patients struggling with FCR and anxiety.
Literature
1.
go back to reference Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10:19–28.CrossRefPubMed Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10:19–28.CrossRefPubMed
2.
go back to reference Linden W, Vodermaier A, MacKenzie R, Greig D. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord. 2012;141:343–51.CrossRefPubMed Linden W, Vodermaier A, MacKenzie R, Greig D. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord. 2012;141:343–51.CrossRefPubMed
3.
go back to reference Mitchell AJ, Chan M, Bhatti H, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160–74.CrossRefPubMed Mitchell AJ, Chan M, Bhatti H, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160–74.CrossRefPubMed
4.
go back to reference Vehling S, Koch U, Ladehoff N, et al. Prevalence of affective and anxiety disorders in cancer: systematic literature review and meta-analysis. Psychother Psychosom Med Psychol. 2012;62:249–58.CrossRefPubMed Vehling S, Koch U, Ladehoff N, et al. Prevalence of affective and anxiety disorders in cancer: systematic literature review and meta-analysis. Psychother Psychosom Med Psychol. 2012;62:249–58.CrossRefPubMed
6.
go back to reference Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR. 4th ed. Arlington, VA: American Psychiatric Assoc; 2009. Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR. 4th ed. Arlington, VA: American Psychiatric Assoc; 2009.
7.
go back to reference World Health Organization. The international statistical classification of diseases and related health problems ICD-10: 2012. World Health Organization. The international statistical classification of diseases and related health problems ICD-10: 2012.
8.
go back to reference Mehnert A, Vehling S, Scheffold K, et al. Prevalence of adjustment disorder, acute and posttraumatic stress disorders as well as somatoform disorders in cancer patients—a systematic literature review. Psychother Psychosom Med Psychol. 2013;63(12):466–72.CrossRefPubMed Mehnert A, Vehling S, Scheffold K, et al. Prevalence of adjustment disorder, acute and posttraumatic stress disorders as well as somatoform disorders in cancer patients—a systematic literature review. Psychother Psychosom Med Psychol. 2013;63(12):466–72.CrossRefPubMed
9.
go back to reference Mols F, Helfenrath KA, Vingerhoets AJJM, Coebergh JWW, van de Poll-Franse LV. Increased health care utilization among long-term cancer survivors compared to the average Dutch population: a population-based study. Int J Cancer. 2007;121:871–7.CrossRefPubMed Mols F, Helfenrath KA, Vingerhoets AJJM, Coebergh JWW, van de Poll-Franse LV. Increased health care utilization among long-term cancer survivors compared to the average Dutch population: a population-based study. Int J Cancer. 2007;121:871–7.CrossRefPubMed
10.
go back to reference Beesley V, Eakin E, Steginga S, Aitken J, Dunn J, Battistutta D. Unmet needs of gynaecological cancer survivors: implications for developing community support services. Psychooncology. 2008;17:392–400.CrossRefPubMed Beesley V, Eakin E, Steginga S, Aitken J, Dunn J, Battistutta D. Unmet needs of gynaecological cancer survivors: implications for developing community support services. Psychooncology. 2008;17:392–400.CrossRefPubMed
11.
go back to reference Armes J, Crowe M, Colbourne L, et al. Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol. 2009;27:6172–9.CrossRefPubMed Armes J, Crowe M, Colbourne L, et al. Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol. 2009;27:6172–9.CrossRefPubMed
12.
go back to reference McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK. Predictors of change in unmet supportive care needs in cancer. Psychooncology. 2010;19:508–16.CrossRefPubMed McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK. Predictors of change in unmet supportive care needs in cancer. Psychooncology. 2010;19:508–16.CrossRefPubMed
13.
go back to reference Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ. What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer. 2009;17:1117–28.CrossRefPubMed Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ. What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer. 2009;17:1117–28.CrossRefPubMed
14.
go back to reference Harrison SE, Watson EK, Ward AM, et al. Primary health and supportive care needs of long-term cancer survivors: a questionnaire survey. J Clin Oncol. 2011;29:2091–8.CrossRefPubMed Harrison SE, Watson EK, Ward AM, et al. Primary health and supportive care needs of long-term cancer survivors: a questionnaire survey. J Clin Oncol. 2011;29:2091–8.CrossRefPubMed
15.
go back to reference Chambers SK, Girgis A, Occhipinti S, et al. Psychological distress and unmet supportive care needs in cancer patients and carers who contact cancer helplines. Eur J Cancer Care (Engl). 2012;21:213–23.CrossRef Chambers SK, Girgis A, Occhipinti S, et al. Psychological distress and unmet supportive care needs in cancer patients and carers who contact cancer helplines. Eur J Cancer Care (Engl). 2012;21:213–23.CrossRef
16.
go back to reference Fiszer C, Dolbeault S, Sultan S, Brédart A. Prevalence, intensity, and predictors of the supportive care needs of women diagnosed with breast cancer: a systematic review. Psychooncology. 2014;23:361–74.CrossRefPubMed Fiszer C, Dolbeault S, Sultan S, Brédart A. Prevalence, intensity, and predictors of the supportive care needs of women diagnosed with breast cancer: a systematic review. Psychooncology. 2014;23:361–74.CrossRefPubMed
17.
go back to reference Schmid-Büchi S, Halfens RJG, Müller M, Dassen T, van den Borne B. Factors associated with supportive care needs of patients under treatment for breast cancer. Eur J Oncol Nurs. 2013;17:22–9.CrossRefPubMed Schmid-Büchi S, Halfens RJG, Müller M, Dassen T, van den Borne B. Factors associated with supportive care needs of patients under treatment for breast cancer. Eur J Oncol Nurs. 2013;17:22–9.CrossRefPubMed
18.
go back to reference Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE. Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol. 2000;18:2505–14.PubMed Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE. Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol. 2000;18:2505–14.PubMed
19.
go back to reference Chan JM, Elkin EP, Silva SJ, Broering JM, Latini DM, Carroll PR. Total and specific complementary and alternative medicine use in a large cohort of men with prostate cancer. Urology. 2005;66:1223–8.CrossRefPubMed Chan JM, Elkin EP, Silva SJ, Broering JM, Latini DM, Carroll PR. Total and specific complementary and alternative medicine use in a large cohort of men with prostate cancer. Urology. 2005;66:1223–8.CrossRefPubMed
20.
go back to reference Eakin EG, Strycker LA. Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives. Psychooncology. 2001;10:103–13.CrossRefPubMed Eakin EG, Strycker LA. Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives. Psychooncology. 2001;10:103–13.CrossRefPubMed
21.
go back to reference Ezendam NPM, Nicolaije KAH, Boll D, et al. Health care use among endometrial cancer survivors: a study from PROFILES, a population-based survivorship registry. Int J Gynecol Cancer. 2013;23:1258–65.CrossRefPubMed Ezendam NPM, Nicolaije KAH, Boll D, et al. Health care use among endometrial cancer survivors: a study from PROFILES, a population-based survivorship registry. Int J Gynecol Cancer. 2013;23:1258–65.CrossRefPubMed
22.
go back to reference Lebel S, Tomei C, Feldstain A, Beattie S, McCallum M. Does fear of cancer recurrence predict cancer survivors’ health care use? Support Care Cancer. 2013;21:901–6.CrossRefPubMed Lebel S, Tomei C, Feldstain A, Beattie S, McCallum M. Does fear of cancer recurrence predict cancer survivors’ health care use? Support Care Cancer. 2013;21:901–6.CrossRefPubMed
23.
go back to reference Thewes B, Butow P, Bell ML, et al. Fear of cancer recurrence in young women with a history of early-stage breast cancer: a cross-sectional study of prevalence and association with health behaviours. Support Care Cancer. 2012;20:2651–9.CrossRefPubMed Thewes B, Butow P, Bell ML, et al. Fear of cancer recurrence in young women with a history of early-stage breast cancer: a cross-sectional study of prevalence and association with health behaviours. Support Care Cancer. 2012;20:2651–9.CrossRefPubMed
24.
go back to reference Bleichhardt G, Hiller W. Pathological features, health care utilization, and media use in behavior therapy outpatients with health anxiety. Verhaltenstherapie Verhaltensmedizin. 2006;27:29–41. Bleichhardt G, Hiller W. Pathological features, health care utilization, and media use in behavior therapy outpatients with health anxiety. Verhaltenstherapie Verhaltensmedizin. 2006;27:29–41.
25.
go back to reference Mehnert A, Herschbach P, Berg P, Henrich G, Koch U. Progredienzangst bei Brustkrebspatientinnen–Validierung der Kurzform des Progredienzangstfragebogens PA-F-KF. Z Psychosom Med Psychother. 2006;52:274–88.PubMed Mehnert A, Herschbach P, Berg P, Henrich G, Koch U. Progredienzangst bei Brustkrebspatientinnen–Validierung der Kurzform des Progredienzangstfragebogens PA-F-KF. Z Psychosom Med Psychother. 2006;52:274–88.PubMed
26.
go back to reference Sarkar S, Scherwath A, Schirmer L, et al. Fear of recurrence and its impact on quality of life in patients with hematological cancers in the course of allogeneic hematopoietic SCT. Bone Marrow Transplant. 2014;49:1217–22.CrossRefPubMed Sarkar S, Scherwath A, Schirmer L, et al. Fear of recurrence and its impact on quality of life in patients with hematological cancers in the course of allogeneic hematopoietic SCT. Bone Marrow Transplant. 2014;49:1217–22.CrossRefPubMed
27.
go back to reference Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed
28.
go back to reference Löwe B, Decker O, Müller S, et al. Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care. 2008;46:266–74.CrossRefPubMed Löwe B, Decker O, Müller S, et al. Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care. 2008;46:266–74.CrossRefPubMed
29.
go back to reference Bonevski B, Sanson-Fisher R, Girgis A, Burton L, Cook P, Boyes A. Evaluation of an instrument to assess the needs of patients with cancer. Supportive care review group. Cancer. 2000;88:217–25.CrossRefPubMed Bonevski B, Sanson-Fisher R, Girgis A, Burton L, Cook P, Boyes A. Evaluation of an instrument to assess the needs of patients with cancer. Supportive care review group. Cancer. 2000;88:217–25.CrossRefPubMed
30.
go back to reference Boyes A, Girgis A, Lecathelinais C. Brief assessment of adult cancer patients’ perceived needs: development and validation of the 34-item Supportive Care Needs Survey (SCNS-SF34). J Eval Clin Pract. 2009;15:602–6.CrossRefPubMed Boyes A, Girgis A, Lecathelinais C. Brief assessment of adult cancer patients’ perceived needs: development and validation of the 34-item Supportive Care Needs Survey (SCNS-SF34). J Eval Clin Pract. 2009;15:602–6.CrossRefPubMed
31.
go back to reference Lehmann C, Koch U, Mehnert A. Psychometric properties of the German version of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF34-G). Support Care Cancer. 2012;20:2415–24.CrossRefPubMed Lehmann C, Koch U, Mehnert A. Psychometric properties of the German version of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF34-G). Support Care Cancer. 2012;20:2415–24.CrossRefPubMed
32.
go back to reference Minstrell M, Winzenberg T, Rankin N, Hughes C, Walker J. Supportive care of rural women with breast cancer in Tasmania, Australia: changing needs over time. Psychooncology. 2008;17:58–65.CrossRefPubMed Minstrell M, Winzenberg T, Rankin N, Hughes C, Walker J. Supportive care of rural women with breast cancer in Tasmania, Australia: changing needs over time. Psychooncology. 2008;17:58–65.CrossRefPubMed
33.
go back to reference Griesser A, Vlastos G, Morel L, Beaume C, Sappino A, Haller G. Socio-demographic predictors of high support needs in newly diagnosed breast cancer patients. Eur J Cancer Care. 2011;20:466–74.CrossRef Griesser A, Vlastos G, Morel L, Beaume C, Sappino A, Haller G. Socio-demographic predictors of high support needs in newly diagnosed breast cancer patients. Eur J Cancer Care. 2011;20:466–74.CrossRef
34.
go back to reference Lam WWT, Au AHY, Wong JHF, et al. Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res Treat. 2011;130:531–41.CrossRefPubMed Lam WWT, Au AHY, Wong JHF, et al. Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res Treat. 2011;130:531–41.CrossRefPubMed
35.
go back to reference Maguire R, Papadopoulou C, Kotronoulas G, Simpson MF, McPhelim J, Irvine L. A systematic review of supportive care needs of people living with lung cancer. Eur J Oncol Nurs. 2013;17:449–64.CrossRefPubMed Maguire R, Papadopoulou C, Kotronoulas G, Simpson MF, McPhelim J, Irvine L. A systematic review of supportive care needs of people living with lung cancer. Eur J Oncol Nurs. 2013;17:449–64.CrossRefPubMed
36.
go back to reference Smith A, Hyde YM, Stanford D. Supportive care needs of cancer patients: a literature review. Palliat Support Care. 2014:1–5. Smith A, Hyde YM, Stanford D. Supportive care needs of cancer patients: a literature review. Palliat Support Care. 2014:1–5.
37.
go back to reference Boyes AW, Clinton-McHarg T, Waller AE, Steele A, D’Este CA, Sanson-Fisher RW. Prevalence and correlates of the unmet supportive care needs of individuals diagnosed with a haematological malignancy. Acta Oncol. 2014:1–8. Boyes AW, Clinton-McHarg T, Waller AE, Steele A, D’Este CA, Sanson-Fisher RW. Prevalence and correlates of the unmet supportive care needs of individuals diagnosed with a haematological malignancy. Acta Oncol. 2014:1–8.
38.
go back to reference Beesley VL, Price MA, Webb PM, O’Rourke P, Marquart L, Butow PN. Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs. Psychooncology. 2013;22:1565–71.CrossRefPubMed Beesley VL, Price MA, Webb PM, O’Rourke P, Marquart L, Butow PN. Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs. Psychooncology. 2013;22:1565–71.CrossRefPubMed
39.
go back to reference Kissane D. Beyond the psychotherapy and survival debate: the challenge of social disparity, depression and treatment adherence in psychosocial cancer care. Psychooncology. 2009;18:1–5.CrossRefPubMed Kissane D. Beyond the psychotherapy and survival debate: the challenge of social disparity, depression and treatment adherence in psychosocial cancer care. Psychooncology. 2009;18:1–5.CrossRefPubMed
Metadata
Title
Anxiety and fear of cancer recurrence and its association with supportive care needs and health-care service utilization in cancer patients
Authors
Susanne Sarkar
Leon Sautier
Georgia Schilling
Carsten Bokemeyer
Uwe Koch
Anja Mehnert
Publication date
01-12-2015
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 4/2015
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-015-0434-2

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