Fear of cancer recurrence in breast cancer: A moderated serial mediation analysis of a prospective international study

Health Psychol. 2024 Aug;43(8):603-614. doi: 10.1037/hea0001345. Epub 2024 Apr 22.

Abstract

Objective: Women dealing with breast cancer (BC) face many challenges, one of which is the fear of cancer recurrence (FCR). This study examined whether disease severity predicts FCR 6 months after cancer diagnosis through psychological distress and whether cognitive-emotion regulation moderates this effect.

Method: The study sample included 656 women from Italy (27.5%), Finland (31.9%), Israel (19.8%), and Portugal (20.8%) diagnosed with Stages I-III of BC. Participants' age ranged between 40 and 70 years (M = 54.92, SD = 8.22). Participants were tracked following BC diagnosis and at 3 and 6 months follow-up. Participants filled out self-report questionnaires, including the FCR inventory-short form, the Hospital Anxiety and Depression Scale, and the cognitive-emotion regulation questionnaire along with medical-social-demographic data.

Results: Greater disease severity at baseline indicated by higher cancer stage predicted greater psychological distress, which in turn predicted greater psychological distress at 3 months. The latter predicted greater FCR at 6 months. This serial mediation model was moderated by negative cognitive-emotion regulation. The mediating effect of disease severity on FCR through psychological distress was significant only in women with mean or higher levels of negative cognitive-emotion regulation.

Conclusion: This study suggests that facilitating psychological well-being and effective cognitive-emotion regulation in the early stages after a cancer diagnosis may protect women from FCR. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms* / psychology
  • Emotional Regulation
  • Fear* / psychology
  • Female
  • Finland
  • Humans
  • Israel
  • Italy
  • Middle Aged
  • Neoplasm Recurrence, Local* / psychology
  • Portugal
  • Prospective Studies
  • Psychological Distress
  • Surveys and Questionnaires