Exploring the screening capacity of the Fear of Cancer Recurrence Inventory – Short Form for clinical levels of fear of cancer recurrence

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 two samples.

Methods

Level of FCR in study 1 participants (from an Australian randomised controlled trial: ConquerFear) was compared to FCRI-SF scores. Based on a biopsychosocial interview, clinicians rated participants as having non-clinical, sub-clinical, or clinical FCR. Study 2 participants (from a Canadian FCRI-English validation study) were classified as having clinical or non-clinical FCR using the semi-structured clinical interview for FCR (SIFCR). Receiver Operating Characteristic (ROC) 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: 53years, SD=10.1) participated. Clinicians rated 43% as having clinical FCR. In Study 2, 40 cancer survivors (mean age: 68years, SD=7.0) participated; 25% met criteria for clinical FCR according to the SIFCR. For both Study 1 and 2, ROC 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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