A third of childhood cancer survivors experience fear of recurrence even decades later, according to a study published online Oct. 3 in JAMA Network Open.

Alex Pizzo, from Concordia University in Montreal, and colleagues characterized the prevalence of and risk factors for clinically significant fear of cancer recurrence in adult survivors of childhood cancer. The analysis included 229 participants in the Childhood Cancer Survivor Study (treated at 31 institutions between 1970 and 1999).

The researchers found that among survivors, 16.6 percent reported a clinically significant fear of cancer recurrence, and an additional 15.7 percent reported a high fear of cancer recurrence. There was an association between a clinically significant fear of cancer recurrence and unemployment (prevalence ratio [PR], 2.5), presence of neurologic chronic health conditions (PR, 3.3), treatment with pelvic radiation (PR, 2.9), and amputation or limb-sparing surgery (PR, 2.4). There was an also association observed between a higher risk for clinically significant fear of cancer recurrence and having either elevated anxiety or depression (PR, 2.6), having both elevated (PR, 3.2), and perceived poor health status (PR, 3.0).

“Findings suggest that fear of cancer recurrence should be routinely screened, and clinically significant symptoms intervened upon as a part of survivorship care,” the authors write.

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