Interventions to Reduce Fear of Cancer Recurrence Among People With Cancer: Scoping Review.

[BACKGROUND] Fear of cancer recurrence (FCR) is prevalent among cancer survivors, affecting between 39% and 97% of patients. FCR is associated with impaired concentration, sleep disturbances, decreased quality of life, and increased psychological distress and health care use. To date, the literature lacks a review that summarizes the breadth of psychological interventions available for reducing fear of recurrence.

[OBJECTIVE] This review aims to identify and summarize the evidence on psychological interventions for addressing FCR across all cancers.

[METHODS] The Joanna Briggs Institute method for scoping reviews guided the processes, and we reported the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. We searched 5 databases (CINAHL, PsycInfo, the Cochrane Central Register of Controlled Trials, Embase, and MEDLINE) and 2 gray literature sources (ProQuest Dissertations & Theses Global and the World Health Organization International Clinical Trials Registry). Eligible studies included adults (≥18 years) diagnosed with cancer and evaluated psychological interventions aimed at reducing FCR. Data extraction captured study characteristics, intervention details, outcome effectiveness, and follow-up durations. We synthesized the findings using descriptive summaries and narrative analysis.

[RESULTS] Overall, 5131 articles were screened, and 122 were included in this review; 48 (39.3%) involved patients with breast cancer, 47 (38.5%) focused on patients with multiple cancer types; over half of the studies (n=64, 52.5%) were randomized controlled trials. Only 28 (23%) studies explicitly reported the definition of FCR. Eighteen different measurement tools were used. Blended interventions (different combinations of cognitive behavioral therapy, mindfulness, acceptance and commitment therapy, and other strategies) formed the largest intervention category (n=38, 31.1%), followed by cognitive behavioral therapy interventions (n=26, 21.3%) and mindfulness-based interventions (n=24, 19.7%). Of the included studies, 104 (85.2%) demonstrated significant reductions in FCR. 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 delivered via the website (n=18, 52.9%). Follow-up duration ranged from postintervention to 3 years.

[CONCLUSIONS] FCR has been the focus of an increasing number of studies since 2009, with the majority being randomized controlled trials. Most interventions are delivered face-to-face and rely on trained specialists. Most have had statistically significant results. However, the included studies demonstrated heterogeneity in terms of delivery, duration, and dose, requiring cautious interpretation of intervention effects. Future research should develop consistent guidelines to standardize the definition of FCR, the measurement tools used, and the timing of follow-up assessments. Long-term follow-up data are needed to evaluate the sustained effects.