Construct validity of fear of recurrence among breast cancer survivors

Abstract

Advancements in cancer detection and treatment have improved the life expectancy of today's cancer patients. With patients living longer, many are now facing the challenges of survivorship. One of the most commonly reported problems among cancer survivors is fear of recurrence. Despite a recent proliferation of literature in the area of fear of recurrence, little theoretical and empirical work has been conducted to define and establish the validity of this important construct. To address this gap in the literature, we proposed and tested a cognitive-emotional theory of fear of recurrence. We then evaluated the convergent, discriminant, and concurrent validity of the theory-consistent items. Three hundred early stage breast cancer survivors completed measures of fear of recurrence, cancer-relevant behavioral outcomes (e.g., health care utilization, functional impairment), and other theoretically-related but distinct constructs (e.g., uncertainty intolerance, general health anxiety). We employed sophisticated structural equation modeling techniques to test our theory of fear of recurrence and evaluate its construct validity. Overall, we found support for our hypothesis that fear of recurrence is a unique construct with predictive power. We hope that findings from this study will expand the theoretical basis for fear of recurrence and serve as a foundation for continued research on this important construct.