Testing a model of fear of cancer recurrence or progression: the central role of intrusions, death anxiety and threat appraisal

We recently proposed a model of cancer-related anxiety to account for the etiology and maintenance of clinically significant anxiety in the context of cancer. This study tested predictions arising from the model to explain fear of cancer recurrence or progression (FCR). Patients with cancer were recruited from a research registry or outpatient hospital clinics (n = 211). In bivariate analyses, FCR was associated with metacognitive beliefs, intolerance of uncertainty, core belief disruption, less meaning in life, social constraints, death anxiety, intrusions, threat appraisal, and coping. A hierarchical regression explained 65% of the variance in FCR. FCR was predicted by younger age, intrusions, death anxiety, threat appraisal and meta-cognitions. The findings highlight the importance of both cognitive processes and content in FCR, including intrusions, fears about death and dying, beliefs about worry, and threat appraisals.