title: Fear of cancer recurrence: a theoretical review and its relevance for clinical presentation and management.
abstract: BACKGROUND
  There is increasing recognition of the unique physical and psychosocial concerns of the growing population of cancer survivors. An emerging literature demonstrates that fear of cancer recurrence (FCR) is a problematic long-term and late effect for cancer survivors. In fact, FCR is a top concern, and this article provides a necessary synthesis of the extant research evidence and theory.
  
  
  METHODS
  Literature searches were conducted using databases including MEDLINE and PsychINFO using specified search terms including 'fear of recurrence' and 'worry about recurrence'. A comprehensive narrative review summarizes early empirical findings on FCR including current definitions, assessment tools, clinical presentations, quality of life impact, prevalence, trajectory and risk factors. This paper also critically reviews the relevant theoretical frameworks to best understand these findings and considers multiple psychosocial treatment models that may have relevance for addressing FCR in the clinical setting.
  
  
  RESULTS
  There is evidence of substantial prevalence and quality of life impact of FCR. Several theories (e.g. self-regulation model of illness, a family-based model, uncertainty in illness theory, social-cognitive processing theory, terror management theory) directly or indirectly help conceptualize FCR and inform potential treatment options for those with clinically significant distress or impairment resulting from FCR.
  
  
  CONCLUSIONS
  Further investigation into FCR is warranted to promote evidence-based care for this significant cancer survivorship concern.
authors.affiliation: Christiana Care Health System, Helen F. Graham Cancer Center & Research Institute, Newark, DE, USA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simonelli
authors.affiliation: Christiana Care Health System, Helen F. Graham Cancer Center & Research Institute, Newark, DE, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Siegel
authors.affiliation: Christiana Care Health System, Helen F. Graham Cancer Center & Research Institute, Newark, DE, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Duffy
mesh_terms: D001007:Anxiety / Q000523:psychology; D005239:Fear / Q000523:psychology*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D010698:Phobic Disorders; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D017741:Survivors; D035501:Uncertainty
keywords: cancer; fear of recurrence; oncology; post-traumatic stress; quality of life; worry