COSMIN database

Fear of cancer recurrence: a systematic literature review of self-report measures

Thewes, B., Butow, P., Zachariae, R., Christensen, S., Simard, S., and Gotay, C.
BACKGROUND: Prior research has shown that many cancer survivors experience ongoing fears of cancer recurrence (FCR) and that this chronic uncertainty of health status during and after cancer treatment can be a significant psychological burden. The field of research on FCR is an emerging area of investigation in the cancer survivorship literature, and several standardised instruments for its assessment have been developed.

AIMS: This review aims to identify all available FCR-specific questionnaires and subscales and critically appraise their properties.

METHODS: A systematic review was undertaken to identify instruments measuring FCR. Relevant studies were identified via Medline (1950-2010), CINAHL (1982-2010), PsycINFO (1967-2010) and AMED (1985-2010) databases, reference lists of articles and reviews, grey literature databases and consultation with experts in the field. The Medical Outcomes Trust criteria were used to examine the psychometric properties of the questionnaires.

RESULTS: A total of 20 relevant multi-item measures were identified. The majority of instruments have demonstrated reliability and preliminary evidence of validity. Relatively few brief measures (2-10 items) were found to have comprehensive validation and reliability data available. Several valid and reliable longer measures (>10 items) are available. Three have developed short forms that may prove useful as screening tools.

CONCLUSIONS: This analysis indicated that further refinement and validation of existing instruments is required. Valid and reliable instruments are needed for both research and clinical care.
1099-1611 (Electronic)
Publication year:
Symptom status:
Emotional state
Adults (18-65)
Children (0-18)
Seniors (65+)
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
ASC - Assessment of Survivor Concerns
CARS - Concerns About Recurrence Scale
CRS COMS-QoLS - Concern About Recurrence Subscale of the Collaborative Ocular Melanoma Study—Quality of Life Scale
CRWS - Cancer-related Worries Scale
CWS-A - Cancer Worry Scale (A)
CWS-B - Cancer Worry Scale (B)
DRS-QLACS - Distress-Recurrence Subscale of the Quality of Life in Adult Cancer Survivors Scale
EORTC-RS - European Organization for Research and Treatment of Cancer Recurrence Subscale
FCRI - Fear of Cancer Recurrence Inventory
Fear of Progression Questionnaire
FRI - Fear of Recurrence Index
FRQ - Fear of Recurrence Questionnaire
FRRS - Fear of Relapse/Recurrence Scale
FRSa - Fear of Recurrence Scale (A)
FRSb - Fear of Recurrence Scale (B)
FRS-CPILS - Fear of Recurrence Subscale of the Cancer Problems in Living Scale
FRS - Fear of Recurrence Subscale
MAX-PC-FRS - Fear of Recurrence Subscale of the Memorial Anxiety Scale for Prostate Cancer
WOC-R - Worry of Cancer Scale—Revised
WPCS - Worry About Prostate Cancer Scale