Abstract: Fear of cancer recurrence (FCR) is a pervasive concern for people living with cancer. The rapidly expanding FCR literature has been weakened somewhat by use of miscellaneous FCR measures of varying quality. The Fear of Cancer Recurrence Inventory (FCRI) has been widely used in observational and intervention studies and the FCRI severity subscale, also known as the FCRI-Short Form (FCRI-SF), is often used to identify potential cases of clinically significant FCR. Given the FCRI’s increasing use in research and clinical practice, we aimed to provide an overview, critique, and suggested improvements of the FCRI. Studies citing the original FCRI validation paper were identified and synthesised using narrative and meta-analytic methods. The 42-item FCRI has demonstrated a reasonably robust 7-factor structure across evaluations in multiple languages, although certain subscales (eg, Coping) demonstrate sub-optimal reliability. Confirmation of the cross-cultural equivalence of several FCRI translations is needed. Meta-analysis of FCRI-SF scores revealed a combined weighted mean score of 15.7/36, a little above the lowest proposed cut-off score (≥ 13) for clinical FCR. Depending on the FCRI-SF cut-off used, between 30.0% and 53.9% of the cancer population (ie, patients and survivors) appear to experience sub-clinical or clinical FCR. Higher FCRI scores were associated with younger age and female gender, pain/physical symptoms and psychological morbidity, consistent with the FCR literature generally. Issues regarding the application and interpretation of the FCRI remain. Whether the FCRI is well suited to assessing fear of progression as well as recurrence is unclear, the meaningfulness of the FCRI total score is debatable, and the use of the FCRI-SF to screen for clinical FCR is problematic, as items do not reflect established characteristics of clinical FCR. Refinement of the FCRI is needed for it to remain a key FCR assessment tool in future research and clinical practice.

Keywords: cancer, fear of recurrence, survivorship, oncology, questionnaire, self-report measure


中文翻译：

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聚焦对癌症复发库存的恐惧（FCRI）

摘要：对癌症复发的恐惧是癌症患者普遍关心的问题。快速发展的FCR文献已通过使用各种质量不同的FCR措施而有所减弱。恐惧癌症复发量表（FCRI）已广泛用于观察和干预研究，并且FCRI严重程度子量表（也称为FCRI简短表格（FCRI-SF））通常用于识别具有临床意义的FCR的潜在病例。鉴于FCRI在研究和临床实践中的使用越来越多，我们旨在概述，批评和建议FCRI的改进。引用原始FCRI验证文件的研究经过鉴定和荟萃分析并进行了综合。42个项目的FCRI在多种语言的评估中展示了相当稳定的7因子结构，尽管某些量表（例如应对）表现出次优的可靠性。需要确认一些FCRI翻译的跨文化等效性。对FCRI-SF评分的荟萃分析显示，合并加权平均评分为15.7 / 36，略高于临床FCR的最低建议截止评分（≥13）。根据所用的FCRI-SF临界值，大约30.0％至53.9％的癌症人群（即患者和幸存者）似乎经历了亚临床或临床FCR。较高的FCRI分数与年龄和性别，疼痛/身体症状和心理发病率有关，这与FCR文献总体上是一致的。有关FCRI的应用和解释的问题仍然存在。目前尚不清楚FCRI是否非常适合评估对进展以及复发的恐惧，FCRI总分的意义尚不明确，使用FCRI-SF筛查临床FCR是有问题的，因为这些项目不能反映临床FCR的既定特征。需要对FCRI进行改进，使其在未来的研究和临床实践中仍是关键的FCR评估工具。

关键词：癌症，对复发的恐惧，生存率，肿瘤学，问卷调查，自我报告措施