An integrative review on factors contributing to fear of cancer recurrence among young adult breast cancer survivors

Background: Fear of cancer recurrence (FCR) is the most prevalent need among breast cancer survivors. Age is the most consistent predictor of higher FCR, with prevalence rates as high as 70% among young adults. Although the association between age and higher FCR is well established, a more comprehensive understanding of the factors contributing to higher FCR among young adult breast cancer survivors is needed. Objective: The purpose of this integrative review was to explore the factors associated with higher FCR among young adult breast cancer survivors (≤ 45 years old). Methods: A literature search was conducted using PubMed, CINAHL, PsycINFO, and EMBASE databases with specific Medical Subject Headings terms delimited to FCR, diagnosis, sex, and age range. The initial search yielded 378 studies, 13 of which met the eligibility criteria. Results: Themes include motherhood status, health behaviors and decision making (eg, surveillance behaviors and surgical decision making), psychological morbidity, and social support. Cognitive behavioral factors include cognitive processing, metacognition, illness intrusiveness, and self-efficacy. Conclusion: Fear of cancer recurrence among young adult breast cancer survivors is a unique construct requiring further exploration and tailored interventions to improve the health-related quality of life for this population. Implications for Practice: Oncology nurses should screen all cancer survivors for FCR, with particular attention to the unique needs of young adults. Future research should address the role of age-appropriate support and increased levels of FCR during surveillance periods.