Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

A systematic review and meta-analysis of caregiver fear of cancer recurrence: Levels, measures, and associations (#493)

Kyra Webb 1 2 , Louise Sharpe 1 , Phyllis Butow 1 2 , Haryana Dhillon 1 2 3 , Robert Zachariae 4 5 , Nina Møller Tauber 4 , Mia Skytte O’Toole 4 , Joanne Shaw 1 2
  1. School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  2. The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  3. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  4. Department of Psychology and Behavioural Sciences , Aarhus University, Aarhus, Denmark
  5. Unit for Psychooncology and Health Psychology (EPoS), Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

Aims: Substantial research has explored survivor fear of cancer recurrence (FCR), however, less is known about caregiver FCR. This study aimed to conduct a meta-analysis to (a) quantify the severity of FCR among caregivers; (b) compare caregiver and survivor FCR levels; (c) examine the relationship between caregiver FCR and depression and anxiety; (d) evaluate the psychometric properties of measures used to quantify caregiver FCR. 

Methods: Databases, CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research exploring caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR, published in English-language, peer-review journals between 1997 and November 2022. The COSMIN taxonomy was used to assess measure content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906).

Results: Of 4297 records screened, 45 met criteria for inclusion. A meta-analysis confirmed that 48% of caregivers experience clinically significant FCR levels (k= 13). Caregiver FCR was as high as FCR amongst survivors. Large associations between caregiver FCR and anxiety (k= 12; r= .561, p< .001; 95% CI 0.453 to 0.653) and caregiver FCR and depression (k= 11; r= .533, p< .001, 95% CI 0.447 to 0.609) were found. Assessment using the COSMIN taxonomy found few instruments had undergone appropriate development and psychometric testing in caregiver populations. Only one instrument scored higher than 50% indicating substantial development and validation components were missing in most.

Conclusions: Results indicate that FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with increased levels of depression and anxiety. Measurement of caregiver FCR has predominately relied on survivor conceptualisations and unvalidated measures. There is an urgent need for more caregiver specific FCR research.