JMIR Publications

ABSTRACT

Background:

Fear of cancer recurrence (FCR) is a prevalent psychological concern among cancer survivors, affecting between 39% and 97% of patients, with up to 87% experiencing moderate to high levels. FCR is associated with impaired concentration, sleep disturbances, decreased quality of life, and increased psychological distress and healthcare utilisation. Despite its impact, FCR often remains unaddressed in survivorship care. A prior scoping review summarised 35 psychological interventions for FCR, focusing exclusively on cognitive-behavioural approaches and including protocols without outcome data. To address this gap, we conducted a comprehensive scoping review of 122 studies examining a wide range of psychological interventions for FCR across cancer types. This review maps how FCR is defined and measured, intervention characteristics, target populations, study designs, and outcomes, aiming to identify effective strategies and evidence gaps.

Objective:

To identify and summarise the evidence on psychological interventions for addressing fear of cancer recurrence across all cancers.

Methods:

The Joanna Briggs Institute method for scoping reviews guided the processes. We pre-registered the review protocol on the Open Science Framework. We searched CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, ProQuest Dissertations & Theses Global, and the World Health Organisation International Clinical Trials Registry up to April 2024.

Results:

5,131 articles were screened, and 122 were included in this review; 48 (39.3%) involved patients with breast cancer, 46 (37.7%) focused on patients with multiple cancer types. Blended interventions (different combinations of cognitive behavioural therapy, mindfulness, acceptance and commitment therapy and other strategies) formed the largest intervention category (n=38, 31.1%), followed by cognitive behavioural therapy interventions (n=26, 21.3%) and mindfulness-based interventions (n=24, 19.7%). Most interventions were delivered face-to-face by disciplinary specialists (n=75, 61.5%), while some were delivered remotely (n=34, 27.9%), with the majority of these via Website (n=18, 52.9%).

Conclusions:

Fear of cancer recurrence has been addressed by psychological interventions. However, most existing interventions are resource intensive, limiting their scalability and accessibility.