Factors associated with high fear of cancer recurrence in young- and middle-aged patients with lung cancer:A cross-sectional study applying the social-ecological model

Objectives To identify the factors associated with FCR in young- and middle-aged patients with lung cancer (LC) by applying the social-ecological mode through a cross-sectional study design. Methods A total of 16 5 patients aged 18–64 years at diagnosis, were recruited to completed the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Brief Illness Perception Questionnaire, Perceived Social Support Scale, Brief Fatigue Inventory, and Hospital Anxiety and Depression scale. Self-reported questionnaires and electronic medical records were used for collecting sociodemographic and clinical variables. Results The mean FoP-Q-SF score was 30.12 ± 10.12; 59 patients (35.8%) had high FCR as indicated by a score of ≥ 34. Multiple linear regression analyses showed that factors in the intrapersonal level including female ( p < 0.001), illness perception ( p < 0.01), and fatigue (p < 0.01), and factors in the interpersonal level including only child ( p < 0.01) and social support (p < 0.01), and the factor in the social-economic level including working status( p < 0.000), were independent predictors of high FCR. Conclusions Multiple factors influence FCR in young- and middle-aged patients with LC.We suggest screening and early detection of FCR based on the above predictors. Meanwhile,multidimensional perspectives, including intrapersonal, interpersonal, and social-economic levels, should be used to develop comprehensive FCR management strategies.