Fear of Cancer Recurrence Among Uninsured and Underrepresented Men With Prostate Cancer.

[OBJECTIVE] To characterize the prevalence of fear of cancer recurrence (FCR) and examine demographic, clinical, and psychosocial factors associated with high FCR among low-income, racially and ethnically diverse prostate cancer survivors treated with definitive therapy for localized disease.

[METHODS] We conducted a retrospective, cross-sectional analysis of 150 participants enrolled in the Men's Health Study (2001-2007) who completed the FCR Survey at baseline. High FCR was defined as a score ≤14 (lower tertile). Demographic, clinical, and patient-reported outcomes were assessed, including health-related quality of life (SF-12v2), prostate-specific quality of life (PCI-SF), symptom distress, spirituality, patient-physician interaction (PEPPI), and treatment regret.

[RESULTS] High FCR was reported by 28% of participants. Sociodemographic and clinical variables-including age, race/ethnicity, treatment, clinical T stage, grade, PSA, and comorbidities-were not associated with FCR. High FCR correlated strongly with poorer mental health, lower SF-12 mental composite scores, and emotional limitations. Treatment regret was significantly more prevalent among those with high FCR (95.2% vs 28.7%, P<.001). Physical health and prostate-specific quality of life did not differ by FCR level.

[CONCLUSION] Nearly one-third of uninsured, underrepresented prostate cancer survivors experienced high FCR, driven by emotional distress and decisional regret rather than objective clinical risk, underscoring the need for equitable, patient-centered survivorship care that supports psychological well-being and promoting patient informed decision-making.