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Journal of Cancer Survivorship

Erschienen in:

19.10.2018

Assessing the relationship between fear of cancer recurrence and health care utilization in early-stage breast cancer survivors

verfasst von: Amy K. Otto, Emily C. Soriano, Scott D. Siegel, Stefanie T. LoSavio, Jean-Philippe Laurenceau

Erschienen in: Journal of Cancer Survivorship | Ausgabe 6/2018

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Abstract

Purpose

The purpose of this study was to determine whether fear of cancer recurrence (FCR) is associated with greater health care utilization (HCU) in early-stage breast cancer survivors.

Methods

Three hundred early-stage breast cancer survivors diagnosed within the past 7 years reported on FCR as well as calls and visits to oncology providers and primary care providers during the preceding 3 months. Participants also reported on use of mental health services and psychotropic medications since diagnosis. Structural equation modeling was used to create a latent FCR factor and evaluate this factor as a predictor of various HCU outcomes controlling for age at diagnosis, years since diagnosis, generalized anxiety, objective risk of recurrence, and number of comorbidities.

Results

FCR predicted more visits to both oncology providers (RR = 1.53, p = .002) and primary care providers (RR = 1.31, p = .013), as well as more phone calls to oncology providers (RR = 2.08, p = .007). FCR was not a significant predictor of phone calls to primary care providers (RR = 1.39, p = .054), utilization of mental health treatment (OR = 1.27, p = .362), or use of psychotropic medications (OR = 1.37, p = .178).

Conclusions

FCR was associated with increases in some types of HCU, which may reflect excessive medical reassurance-seeking and lead to unnecessary medical costs.

Implications for Cancer Survivors

FCR is a serious concern that warrants greater attention to reduce distress-related health care utilization. Utilization of mental health services to address FCR may represent higher-value health care.

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The FCRI Severity subscale has been used in previous research as an indicator of clinically-significant FCR; when items are scaled from 0-4 and summed, a score of 13 or greater is indicative of clinical levels of FCR [26]. To facilitate comparisons to past work, we provide descriptive information about FCR scores based on these clinical guidelines: In the present sample, mean FCRI Severity score was 14.97 (SD = 7.77). Over half of patients (53.9% in the present sample scored 13 or greater on the FCRI Severity subscale and would therefore be considered to have clinical levels of FCR.

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Titel: Assessing the relationship between fear of cancer recurrence and health care utilization in early-stage breast cancer survivors
verfasst von: Amy K. Otto
Emily C. Soriano
Scott D. Siegel
Stefanie T. LoSavio
Jean-Philippe Laurenceau
Publikationsdatum: 19.10.2018
Verlag: Springer US
Erschienen in: Journal of Cancer Survivorship / Ausgabe 6/2018
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-018-0714-8

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Assessing the relationship between fear of cancer recurrence and health care utilization in early-stage breast cancer survivors

Abstract

Purpose

Methods

Results

Conclusions

Implications for Cancer Survivors

Neu im Fachgebiet Onkologie

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Implications for Cancer Survivors

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