Effectiveness of a stepped-care model to address fear of cancer recurrence in patients with early-stage melanoma: results at 6- and 12-month follow-up

Thompson, JR; Gomes, L; Kouvelis, G; Smith, AL; Lo, SN; Kasparian, NA; Saw, RPM; Dieng, M; Seaman, L; Martin, LK; Guitera, P; Milne, D; Schmid, H; Cust, AE; Bartula, I

Author(s): Thompson, JR; Gomes, L; Kouvelis, G; Smith, AL; Lo, SN; Kasparian, NA; Saw, RPM; Dieng, M; Seaman, L; Martin, LK; Guitera, P; Milne, D; Schmid, H; Cust, AE; Bartula, I;
Details: Publication Year 2026-01,Volume 34,Issue #1,Page 58
Journal Title: Supportive Care in Cancer
Publication Type: Research article
Abstract: PURPOSE: To investigate the effectiveness of the Melanoma Care Program, an evidence-based, psychological intervention delivered through a stepped-care model, to address fear of cancer recurrence (FCR) in patients with early-stage melanoma at 6- and 12-month follow-up, when implemented into routine practice. METHODS: Individuals with stage 0-II melanoma participated in FCR severity screening using the Fear of Cancer Recurrence Inventory. Participants with an FCR severity score of ≤ 12 were offered usual care. Participants with an FCR severity score of ≥ 13 were offered a psychoeducational booklet and a stepped-care model offering participants up to 5 psychotherapeutic telehealth sessions with a clinical psychologist. Multivariable linear mixed modelling was used to analyse outcomes at 1 week, 6 months, and 12 months post-intervention, including FCR severity (primary outcome), symptoms of depression, anxiety, and stress, melanoma-related knowledge, and health-related quality of life. RESULTS: One hundred and forty-three participants (111 women, mean age of 54.6 years) were screened; 115 (80%) participants had an FCR severity score ≥ 13, and of these, 112 (97%) participated in the intervention. Seventy-four participants (66%) completed 12-month follow-up. Adjusted multivariable linear mixed modelling demonstrated that the significant reduction in FCR severity found at 1 week post-intervention (mean change from baseline: -3.79; 95% CI: -4.72, -2.85; p < 0.001) was maintained at 6 months (mean change from baseline: -4.28; 95% CI: -5.30, -3.27; p < 0.001) and 12 months (mean change from baseline: -4.59; 95% CI: -5.62, -3.57; p < 0.001). CONCLUSIONS: The Melanoma Care Program maintained effectiveness at 6- and 12-month follow-up when implemented into routine clinical practice for people with early-stage melanoma.
Keywords: Humans; Female; *Melanoma/psychology/pathology/therapy; Male; Middle Aged; Follow-Up Studies; *Neoplasm Recurrence, Local/psychology; *Fear/psychology; Adult; Quality of Life; Aged; *Skin Neoplasms/psychology/pathology; Neoplasm Staging; Severity of Illness Index; Telemedicine; Anxiety/etiology/therapy; Depression/etiology; Linear Models; Fear of cancer recurrence; Implementation; Melanoma; Psychological intervention; Screening; Stepped-care
Department(s): Surgical Oncology
Publisher's Version: https://doi.org/10.1007/s00520-025-10282-6
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-01-23 05:48:33

Last Modified: 2026-01-23 05:50:32