title: Psychological morbidity and stress but not social factors influence level of fear of cancer recurrence in young women with early breast cancer: results of a cross-sectional study.
abstract: BACKGROUND
  Fear of cancer recurrence (FCR) is a common problem amongst survivors. Past research has shown that young women with breast cancer are particularly vulnerable to FCR, yet few previous studies have specifically examined FCR in this subgroup.
  
  
  OBJECTIVE
  The aim of the study is to explore the relationship between FCR, psychological morbidity and social factors. A secondary aim was to explore the relationship between clinical levels of FCR and generalised anxiety disorder (GAD) and hypochondriasis.
  
  
  METHODS
  Two hundred eighteen breast cancer survivors (aged 18-45 years at diagnosis) diagnosed at least 1 year prior were recruited through seven metropolitan oncology clinics and two breast cancer consumer groups. Participants completed a web-based questionnaire, which assessed FCR, psychological functioning, generalised anxiety, hypochondriasis and items exploring past cancer-related experiences, attitudes to future childbearing, social support and correlates were identified using linear regression.
  
  
  RESULTS
  Psychological morbidity scales measuring anxiety and psychological functioning and stressful life events were significantly associated with FCR in adjusted and unadjusted models (p < 0.0001). Past cancer experiences, children, social support and attitudes to childrearing were not associated with FCR. Among those with clinical levels of FCR (n = 152), 43% met screening criteria for hypochondriasis, and 36% met screening criteria for GAD.
  
  
  CONCLUSIONS
  This study shows psychological morbidity is associated with FCR, but the majority of women with high levels of FCR do not also meet the criteria for a clinical level of GAD or hypochondriasis. Understanding the factors that make young women vulnerable to FCR is important to help guide the development of FCR-specific interventions for this subgroup.
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Thewes
authors.forename: M L
authors.initials: ML
authors.lastname: Bell
authors.forename: P
authors.initials: P
authors.lastname: Butow
authors.forename: J
authors.initials: J
authors.lastname: Beith
authors.forename: F
authors.initials: F
authors.lastname: Boyle
authors.forename: M
authors.initials: M
authors.lastname: Friedlander
authors.forename: S A
authors.initials: SA
authors.lastname: McLachlan
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology*; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D006998:Hypochondriasis / Q000523:psychology*; D008875:Middle Aged; D008960:Models, Psychological; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000523:psychology*; D009367:Neoplasm Staging; D012307:Risk Factors; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: breast cancer; cancer; comorbidity; fear of recurrence; oncology