title: Does fear of cancer recurrence predict cancer survivors' health care use?
abstract: BACKGROUND
  Fear of cancer recurrence (FCR) is the most frequently cited unmet need among cancer survivors. Theoretical models of FCR suggest that patients with elevated levels of FCR will more frequently consult health care professionals for reassurance about their health. However, the relationship between FCR and health care utilization has not yet been firmly established. We examined the relationship between FCR and quantity of medications, number of emergency room (ER) visits, outpatient visits, specialist visits, allied health visits, and hospital overnight visits.
  
  
  METHODS
  A total of 231 participants diagnosed with breast, colon, prostate, or lung cancer in the past 10 years were recruited from a cancer survivor registry. Participants were sent a survey package that included demographic and medical characteristics, a health care utilization questionnaire, and the Fear of Cancer Recurrence Inventory.
  
  
  RESULTS
  A multiple regression analysis indicated that higher FCR significantly predicted greater number of outpatient visits in the past 6 months (ß = .016, F(1, 193) = 5.08, p = .025). A hierarchical multiple regression indicated that higher FCR significantly predicted greater number of ER visits in the past 6 months when controlling for relationship status and education level (F(1, 179) = 4.00, p = .047).
  
  
  CONCLUSIONS
  The relationship between FCR and health care use has been understudied. Results indicate that patients with elevated FCR may indeed use more health care services. We recommend that clinicians monitor health care use in patients who are struggling with FCR.
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, Ontario, Canada. slebel@uottawa.ca
authors.forename: Sophie
authors.initials: S
authors.lastname: Lebel
authors.forename: Christina
authors.initials: C
authors.lastname: Tomei
authors.forename: Andrea
authors.initials: A
authors.lastname: Feldstain
authors.forename: Sara
authors.initials: S
authors.lastname: Beattie
authors.forename: Megan
authors.initials: M
authors.lastname: McCallum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005239:Fear; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D012044:Regression Analysis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*