title: Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation.
abstract: Fear of cancer recurrence (FCR) is prevalent among survivors. However, a comprehensive and universally accepted theoretical framework of FCR to guide intervention is lacking. This paper reviews theoretical frameworks previously used to explain FCR and describes the formulation of a novel theoretical framework for FCR.
  
  
  
  A systematic review of the literature was undertaken to identify conceptual frameworks or theories applied to FCR. MEDLINE, PubMED, CINAHL, AMED, PsycINFO and Web of Science were searched. Identified conceptual frameworks were reviewed for strength of evidence supporting their validity.
  
  
  
  Of 558 papers initially identified, 16 made reference to six different conceptual frameworks relating to FCR. The most comprehensive and evidence-based theoretical approach is the Common Sense Model (CSM). Other approaches have limited evidence supporting their application to FCR. Two theoretical approaches developed in the context of emotional disorders that appear to be highly relevant to FCR: the Self-Regulatory Executive Function (S-REF) model and Relational Frame Theory were combined with the CSM to produce a novel cognitive processing account of FCR.
  
  
  
  Few conceptual frameworks have been used consistently to guide FCR research, and not all frameworks are empirically well supported, suggesting that further discussion regarding the conceptualisation of FCR is needed. The novel theoretical framework for FCR presented highlights the multidimensional nature of FCR and the importance of cognitive processing and metacognitions in the development and maintenance of FCR.
  
  
  
  The novel theoretical formulation of FCR outlined here provides a much-needed comprehensive framework to further investigate and address FCR in cancer survivors.
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia.|Behavioural Sciences Unit, School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors.forename: Joanna E
authors.initials: JE
authors.lastname: Fardell
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia.|Department of Medical Psychology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen (840), The Netherlands.
authors.forename: Belinda
authors.initials: B
authors.lastname: Thewes
authors.affiliation: Mental Health Centre, School of Medicine, University of Queensland, St Lucia, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Turner
authors.affiliation: Crown Princess Mary Cancer Centre, Breast Cancer Institute, Westmead Hospital, Sydney, Australia.
authors.forename: Jemma
authors.initials: J
authors.lastname: Gilchrist
authors.affiliation: School of Psychology, University of Sydney, Sydney, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Sharpe
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia.
authors.forename: Allan 'Ben'
authors.initials: A'
authors.lastname: Smith
authors.affiliation: Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
authors.affiliation: Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia. phyllis.butow@sydney.edu.au.|Chris O'Brien Lifehouse (C39Z), School of Psychology, The University Of Sydney, Sydney, Australia. phyllis.butow@sydney.edu.au.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
mesh_terms: D003071:Cognition; D005239:Fear / Q000523:psychology*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D010698:Phobic Disorders / Q000523:psychology*; D017741:Survivors / Q000523:psychology*
keywords: Acceptance and Commitment Therapy; Cancer; Fear of cancer recurrence; Metacognitive Therapy; Oncology; Survivorship