Joanna E Fardell1,2, Georden Jones3, Allan Ben Smith1,4, Sophie Lebel3,5, Belinda Thewes1,6, Daniel Costa1,7, Kerry Tiller8, Sébastien Simard9, Andrea Feldstain3, Sara Beattie3, Megan McCallum3, Phyllis Butow1. 1. Psycho-Oncology Co-operative Research Group, School of Psychology, University of Sydney, Sydney, New South Wales, Australia. 2. Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia. 3. School of Psychology, University of Ottawa, Ottawa, ON, Canada. 4. Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, SWS Clinical School, University of New South Wales, Kensington, New South Wales, Australia. 5. Institut de Recherche de l'Hôpital Montfort, Ottawa, ON, Canada. 6. Department Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands. 7. Pain Management Research Institute, Royal North Shore Hospital, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 8. Prince of Wales Hospital, Sydney, New South Wales, Australia. 9. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, QC, Canada.
Abstract
OBJECTIVE: Fear of cancer recurrence (FCR) is a common concern among cancer survivors. Identifying survivors with clinically significant FCR requires validated screening measures and clinical cut-offs. We evaluated the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) clinical cut-off in 2 samples. METHODS: Level of FCR in study 1 participants (from an Australian randomized controlled trial: ConquerFear) was compared with FCRI-SF scores. Based on a biopsychosocial interview, clinicians rated participants as having nonclinical, subclinical, or clinical FCR. Study 2 participants (from a Canadian FCRI-English validation study) were classified as having clinical or nonclinical FCR by using the semistructured clinical interview for FCR (SIFCR). Receiver operating characteristic analyses evaluated the screening ability of the FCRI-SF against clinician ratings (study 1) and the SIFCR (study 2). RESULTS: In study 1, 167 cancer survivors (mean age: 53 years, SD = 10.1) participated. Clinicians rated 43% as having clinical FCR. In study 2, 40 cancer survivors (mean age: 68 years, SD = 7.0) participated; 25% met criteria for clinical FCR according to the SIFCR. For both studies 1 and 2, receiver operating characteristic analyses suggested a cut-off ≥22 on the FCRI-SF identified cancer survivors with clinical levels of FCR with adequate sensitivity and specificity. CONCLUSIONS: Establishing clinical cut-offs on FCR screening measures is crucial to tailoring individual care and conducting rigorous research. Our results suggest using a higher cut-off on the FCRI-SF than previously reported to identify clinically significant FCR. Continued evaluation and validation of the FCRI-SF cut-off is required across diverse cancer populations.
OBJECTIVE: Fear of cancer recurrence (FCR) is a common concern among cancer survivors. Identifying survivors with clinically significant FCR requires validated screening measures and clinical cut-offs. We evaluated the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) clinical cut-off in 2 samples. METHODS: Level of FCR in study 1 participants (from an Australian randomized controlled trial: ConquerFear) was compared with FCRI-SF scores. Based on a biopsychosocial interview, clinicians rated participants as having nonclinical, subclinical, or clinical FCR. Study 2 participants (from a Canadian FCRI-English validation study) were classified as having clinical or nonclinical FCR by using the semistructured clinical interview for FCR (SIFCR). Receiver operating characteristic analyses evaluated the screening ability of the FCRI-SF against clinician ratings (study 1) and the SIFCR (study 2). RESULTS: In study 1, 167 cancer survivors (mean age: 53 years, SD = 10.1) participated. Clinicians rated 43% as having clinical FCR. In study 2, 40 cancer survivors (mean age: 68 years, SD = 7.0) participated; 25% met criteria for clinical FCR according to the SIFCR. For both studies 1 and 2, receiver operating characteristic analyses suggested a cut-off ≥22 on the FCRI-SF identified cancer survivors with clinical levels of FCR with adequate sensitivity and specificity. CONCLUSIONS: Establishing clinical cut-offs on FCR screening measures is crucial to tailoring individual care and conducting rigorous research. Our results suggest using a higher cut-off on the FCRI-SF than previously reported to identify clinically significant FCR. Continued evaluation and validation of the FCRI-SF cut-off is required across diverse cancer populations.
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