PURPOSE: Fear of cancer recurrence (FCR) is prevalent amongst survivors, and breast cancer survivors are particularly vulnerable. Currently, there are few well-validated brief measures of FCR and none specific to breast cancer. This manuscript describes the development and initial validation of a new measure of FCR for breast cancer survivors, the Concerns about Recurrence Questionnaire (CARQ), and reports its initial validation in an Australian and Danish population-based sample of breast cancer survivors. METHODS: CTT analyses explored scale reliability and validity; Rasch analyses explored model fit statistics, item bias (DIF) and local dependency. Three-item, four-item and five-item versions were considered. RESULTS: Two hundred eighteen Australian women aged 28-45 years diagnosed with early-stage breast cancer (stages 0-2) and 2001 Danish women diagnosed with breast cancer (stages 1-3) aged 26-70 completed the CARQ. Based on the results of both CTT and IRT analyses, the four-item English version of the scale performed best. Although the CTT analyses suggested that the CARQ-4 was reliable and valid in both samples, Rasch analyses identified item bias relative to age, and local dependence which may be remedied by further scale development. CONCLUSIONS: The CARQ-4 English version is currently one of the most rigorously tested brief scales of FCR available. IMPLICATIONS FOR CANCER SURVIVORS: The availability of more valid and reliable brief measures of FCR will help to promote research and screening of FCR amongst cancer survivors.
PURPOSE: Fear of cancer recurrence (FCR) is prevalent amongst survivors, and breast cancer survivors are particularly vulnerable. Currently, there are few well-validated brief measures of FCR and none specific to breast cancer. This manuscript describes the development and initial validation of a new measure of FCR for breast cancer survivors, the Concerns about Recurrence Questionnaire (CARQ), and reports its initial validation in an Australian and Danish population-based sample of breast cancer survivors. METHODS: CTT analyses explored scale reliability and validity; Rasch analyses explored model fit statistics, item bias (DIF) and local dependency. Three-item, four-item and five-item versions were considered. RESULTS: Two hundred eighteen Australian women aged 28-45 years diagnosed with early-stage breast cancer (stages 0-2) and 2001 Danish women diagnosed with breast cancer (stages 1-3) aged 26-70 completed the CARQ. Based on the results of both CTT and IRT analyses, the four-item English version of the scale performed best. Although the CTT analyses suggested that the CARQ-4 was reliable and valid in both samples, Rasch analyses identified item bias relative to age, and local dependence which may be remedied by further scale development. CONCLUSIONS: The CARQ-4 English version is currently one of the most rigorously tested brief scales of FCR available. IMPLICATIONS FOR CANCER SURVIVORS: The availability of more valid and reliable brief measures of FCR will help to promote research and screening of FCR amongst cancer survivors.
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Authors: Elizabeth G Eakin; Sandra C Hayes; Marion R Haas; Marina M Reeves; Janette L Vardy; Frances Boyle; Janet E Hiller; Gita D Mishra; Ana D Goode; Michael Jefford; Bogda Koczwara; Christobel M Saunders; Wendy Demark-Wahnefried; Kerry S Courneya; Kathryn H Schmitz; Afaf Girgis; Kate White; Kathy Chapman; Anna G Boltong; Katherine Lane; Sandy McKiernan; Lesley Millar; Lorna O'Brien; Greg Sharplin; Polly Baldwin; Erin L Robson Journal: BMC Cancer Date: 2015-12-21 Impact factor: 4.430