Background
Fear of cancer recurrence (FCR) is common and, if poorly managed, can lead to survivors avoiding or seeking out healthcare services, including oncology and primary care. This study aimed to assess the FCR and its association on health care utilization in a cohort of cancer survivors in Massachusetts, USA.
Methods
64 cancer survivors (25-73 years old, M=7 years since diagnosis) of non-metastatic cancer who completed primary treatment and had elevated FCR (FCR Inventory severity ≥ 16) completed baseline surveys for a randomized controlled trial testing a virtual, mind-body intervention for FCR. Self-report measures included sociodemographic and medical characteristics, FCR (FCR Inventory severity), and healthcare use in the past 3 months (Medical Expenditure Panel Survey).
Results
Participants were mostly female (82.8%), mean age of 52.41 years (SD = 13.69). Most (92.2%) self-identified as White, 7.8% Black/African American, 1.6% American Indian/Alaska Native, 1.6% Asian, and 4.7% Other. Cancer diagnoses included: breast (45.3%), hematological (17.2%), genitourinary (12.5%), gynecological (7.8%), sarcoma (7.8%), head/neck (6.3%), and melanoma (3.1%). Over half (59.4%) reported at least one comorbid medical condition.
Most (93.8%) reported at least one planned visit in the past 3 months, with an oncology visit being the most frequent (73.4%), followed by primary care (62.5%) and specialty care (50.0%). About one-quarter (26.6%) reported at least one unplanned visit in the prior 3 months, with urgent care being most frequent (20.3%), followed by emergency visits (12.5%), and hospitalizations (7.8%).
On average, FCR was highly elevated 22.9 (SD = 4.6) and led to increased healthcare utilization, including unplanned visits and hospitalizations.
Conclusion and Clinical Implication
FCR is related to unplanned healthcare utilization and therefore has important implications for primary care. Interventions to address FCR, including in primary care settings, have been developed and need implementation.