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Protocol - Fear of Cancer Recurrence

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Description

This 7-item unidimensional scale is a screening instrument that has been used to assess Fear of Cancer Recurrence (FCR) in cancer patients. The FCR7 consists of 4 items that assess the level of worry about cancer recurrence, 2 items that assess the level of interference of FCR with the patient’s thoughts and activities, and 1 item that assesses patient’s behavioral responses. The final item is a scale that represents the experiences of the level (severity) of patients FCR.

Specific Instructions

The user must first ascertain if the person has been diagnosed with cancer.

Protocol

Please answer the following questions by placing a tick in any of the boxes for each of the question.

Not at all

A little

Sometimes

A lot

All the time

Q1: I am afraid that my cancer may recur

 [ ] 1

 [ ] 2

 [ ] 3

 [ ] 4

 [ ] 5

Q2: I am worried or anxious about the possibility of cancer recurrence

 [ ] 1

 [ ] 2

 [ ] 3

 [ ] 4

 [ ] 5

Q3: How often have you worried about the possibility of getting cancer again

 [ ] 1

 [ ] 2

 [ ] 3

 [ ] 4

 [ ] 5

Q4: I get waves of strong feelings about the cancer coming back

 [ ] 1

 [ ] 2

 [ ] 3

 [ ] 4

 [ ] 5

Q5: I think about the cancer returning when I didn’t mean to

 [ ] 1

 [ ] 2

 [ ] 3

 [ ] 4

 [ ] 5

Q6: I examine myself to see if I have physical signs of cancer

 [ ] 1

 [ ] 2

 [ ] 3

 [ ] 4

 [ ] 5

Not at all

A great deal

Q7: To what extent does worry about getting cancer again spill over or intrude on your thoughts and activities

 [ ] 0

 [ ] 1

 [ ] 2

 [ ] 3

 [ ] 4

 [ ] 5

 [ ] 6

 [ ] 7

 [ ] 8

 [ ] 9

 [ ] 10

 † FCR4 is sum of first 4 items (Q1 to Q4)

Scoring

The scoring system is ‘1 = not at all’, ‘2 = a little’, ‘3 = sometimes’, ‘4 = a lot’, and ‘5 = all the time’. The 7th item is used to assess the extent to which FCR interferes with the patient’s thoughts and activities and is scored on a 11-point scale, with a ‘0’ indicating ‘not at all’ and ‘10’ indicating ‘a great deal’. For each individual item, a score ≥4 on questions 1 to 6 (ranging from 1 to 5), or ≥7 on question 7 (ranging from 0 to 10) indicates a significant level (severity) of fear of cancer recurrence6.

Although no definite clinically meaningful cut point is available to decide patients' FCR, the single item or total (sum) scores can be used for screening and to identify patients’ severity of FCR. The total score is ranged from 6 to 40, with higher the score indicating higher level of FCR.

Availability

Available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Adult, Senior

Participants

Adults, ages 18 + who have been diagnosed with cancer

Selection Rationale

Fear of Cancer Recurrence (FCR7) is a screening tool for cancer patients as a basis for providing personalized psychological interventions as it relates to their distress of fear of relapse or cancer recurrence.

Language

English

Standards
StandardNameIDSource
caDSR Common Data Elements (CDE) Cancer Outcome Fear of Cancer Recurrence Assessment Text 7533650 CDE Browser
Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

Fear of Cancer Recurrence (FCR7)

Source

Fear of Cancer Recurrence – 7 items, School of Medicine, University of St. Andrews and Edinburgh Cancer Centre – Western General Hospital, (Humphries et al.,2018).

General References

Yang Y, Cameron J, Humphris G. The relationship between cancer patient’s fear of recurrence and radiotherapy: a systematic review and meta-analysis. Psychooncology. 2017;26:738-46.

Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, et al. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv. 2013;7:300–22. [PubMed]

Thewes B, Butow P, Zachariae R, Christensen S, Simard S, Gotay C. Fear of cancer recurrence: a systematic literature review of self-report measures. Psycho oncology. 2012;21:571–587. doi: 10.1002/pon.2070.

Mitchell AJ, Coyne JC. Do ultra-short screening instruments accurately detect depression in primary care? A pooled analysis and meta-analysis of 22 studies. Br J Gen Pract. 2007;57:144–151.

Protocol ID

320401

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX320401_Fear_Cancer_Recurrence_Afraid
PX320401010000 I am afraid that my cancer may recur N/A
PX320401_Fear_Cancer_Recurrence_Examine_Myself
PX320401060000 I examine myself to see if I have physical more
signs of cancer show less
N/A
PX320401_Fear_Cancer_Recurrence_Extent_Worry_Intrude_Thoughts_Activities
PX320401070000 To what extent does worry about getting more
cancer again spill over or intrude on your thoughts and activities show less
N/A
PX320401_Fear_Cancer_Recurrence_Strong_Feelings
PX320401040000 I get waves of strong feelings about the more
cancer coming back show less
N/A
PX320401_Fear_Cancer_Recurrence_Think_About
PX320401050000 I think about the cancer returning when I more
didn't mean to show less
N/A
PX320401_Fear_Cancer_Recurrence_Worried_Anxious
PX320401020000 I am worried or anxious about the more
possibility of cancer recurrence show less
N/A
PX320401_Fear_Cancer_Recurrence_Worried_Often
PX320401030000 How often have you worried about the more
possibility of getting cancer again show less
N/A
Cancer Outcomes and Survivorship
Measure Name

Fear of Cancer Recurrence

Release Date

December 17, 2020

Definition

Fear of Cancer Recurrence (FCR7) is a 7-item self-report measure of patients’ fear of cancer recurrence. This instrument was developed and validated for cancer survivors to assess the emotional distress caused by concern that their cancer will return or progress after anti-cancer treatment.

Purpose

Assessing fear of recurrence (FCR) is crucial for understanding an important psychological state of people diagnosed with and treated for cancer.

Keywords

Cancer outcomes and survivorship, fear of recurrence, cancer recurrence, FCR, Fear of Relapse, FCR7, relapse, recurrence

Measure Protocols
Protocol ID Protocol Name
320401 Fear of Cancer Recurrence
Publications

There are no publications listed for this protocol.