Fear-of-recurrence review

Fear that cancer will come back is now being treated as a survivorship problem in its own right, after a new review found dozens of psychological approaches linked to lower distress. (cancer.jmir.org) The review, published April 22 in *JMIR Cancer*, screened 5,131 articles and included 122 studies of adults with cancer. More than half of the included studies, 64 of 122, were randomized controlled trials. (cancer.jmir.org) The authors found fear of cancer recurrence was reported in 39% to 97% of survivors and was tied to impaired concentration, sleep disturbance, lower quality of life, greater psychological distress, and higher health care use. They said 104 of the 122 included studies reported significant reductions in fear of recurrence after treatment. (cancer.jmir.org; pmc.ncbi.nlm.nih.gov) Fear of recurrence means the worry that cancer has returned or will return after treatment. In psycho-oncology, the specialty that studies the mental health effects of cancer, that worry has become one of the most common unmet needs reported by survivors. (pmc.ncbi.nlm.nih.gov; cancer.jmir.org) The review found the evidence base is broad but uneven. Breast cancer accounted for 48 of the 122 studies, or 39.3%, and another 47 studies, or 38.5%, grouped multiple cancer types together. (cancer.jmir.org) Researchers also found little standardization in how the field measures the problem. Only 28 studies, or 23%, explicitly defined fear of recurrence, and the 122 studies used 18 different measurement tools. (cancer.jmir.org) The largest group of interventions blended several methods, including cognitive behavioral therapy, mindfulness, and acceptance and commitment therapy. Those mixed programs made up 38 studies, followed by 26 cognitive behavioral therapy studies and 24 mindfulness-based studies. (pmc.ncbi.nlm.nih.gov) Most programs were still delivered face to face by specialists: 75 studies, or 61.5%, used in-person delivery. Another 34 studies, or 27.9%, used remote formats, and 18 of those remote programs were delivered through websites. (pmc.ncbi.nlm.nih.gov) That shift toward remote care is already showing up in newer trials. A November 2025 randomized clinical trial in *JAMA Network Open* found a 10-week therapist-guided online program reduced fear-of-recurrence scores in 95 long-term colorectal cancer survivors in Denmark. (jamanetwork.com) A 2022 individual-participant meta-analysis, which pooled data from 9,311 respondents in 13 countries, found 45.1% scored above a common clinical cutoff on a validated fear-of-recurrence scale. The new review points to the same conclusion from a different angle: survivorship care is increasingly measuring the scan, symptom, or follow-up visit that can trigger fear long after treatment ends. (pmc.ncbi.nlm.nih.gov; cancer.jmir.org)