Evaluation of the validity and screening performance of a revised single-item fear of cancer recurrence screening measure (FCR-1r)

Smith, A; Gao, M; Tran, M; Ftanou, M; Jegathees, S; Wu, V; Jefford, M; Lynch, F; Dhillon, HM; Shaw, J; McDowell, L; White, A; Halloran, C; Wiesenfeld, D; Bamgboje-Ayodele, A

Author(s): Smith, A; Gao, M; Tran, M; Ftanou, M; Jegathees, S; Wu, V; Jefford, M; Lynch, F; Dhillon, HM; Shaw, J; McDowell, L; White, A; Halloran, C; Wiesenfeld, D; Bamgboje-Ayodele, A;
Details: Publication Year 2023-06,Volume 32,Issue #6,Page 961-971
Journal Title: Psycho-Oncology
Publication Type: Research article
Abstract: OBJECTIVE: Fear of cancer recurrence (FCR) is highly prevalent among cancer survivors, but irregularly identified in practice. Single-item FCR measures suitable for integration into broader psychosocial screening are needed. This study evaluated the validity of a revised version of the original FCR-1 (FCR-1r) and screening performance alongside the Edmonton Symptom Assessment System - Revised (ESAS-r) anxiety item. METHODS: The FCR-1r was adapted from the FCR-1 and modelled on the ESAS-r. Associations between FCR-1r and FCR Inventory-Short Form (FCRI-SF) scores determined concurrent validity. Relationships of FCR-1r scores with variables related (e.g., anxiety, intrusive thoughts) and unrelated (e.g., employment/marital status) to FCR determined convergent and divergent validity respectively. A Receiver-Operating Characteristic analysis examined screening performance and cut-offs for the FCR-1r and ESAS-r anxiety item. RESULTS: 107 participants were recruited in two studies (Study 1, July-October 2021, n = 54; Study 2: November 2021-May 2022, n = 53). The FCR-1r demonstrated concurrent validity against the FCRI-SF (r = 0.83, p < 0.0001) and convergent validity versus the Generalised Anxiety Disorder-7 (r = 0.63, p < 0.0001) and Impact of Event Scale-Revised Intrusion subscale (r = 0.55, p < 0.0001). It did not correlate with unrelated variables (e.g., employment/marital status), indicating divergent validity. An FCR-1r cut-off >/=5/10 had 95% sensitivity and 77% specificity for detecting clinical FCR (area under the curve (AUC) = 0.91, 95% CI 0.85-0.97, p < 0.0001); ESAS-r anxiety cut-off >/=4 had 91% sensitivity and 82% specificity (AUC = 0.87, 95% CI 0.77-0.98, p < 0.0001). CONCLUSIONS: The FCR-1r is a valid and accurate tool for FCR screening. Further evaluation of the screening performance of the FCR-1r versus the ESAS-r anxiety item in routine care is needed.
Publisher: Wiley
Keywords: Humans; *Early Detection of Cancer; Neoplasm Recurrence, Local/diagnosis/psychology; Fear/psychology; Anxiety/diagnosis/psychology; *Phobic Disorders/psychology; Esas; cancer; cancer survivorship; fear of cancer recurrence; fear of progression; oncology; patient-reported outcome measures; psycho-oncology; screening; single-item measure
Department(s): Australian Cancer Survivorship Centre; Health Services Research; Radiation Oncology; Psychosocial Oncology
PubMed ID: 37120796
Publisher's Version: https://doi.org/10.1002/pon.6139
Open Access at Publisher's Site: https://doi.org/10.1002/pon.6139
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-08-07 07:16:16

Last Modified: 2023-08-07 07:17:40