Poster Presentation NSW State Cancer Conference 2023

Caregiver fear of cancer recurrence levels, measures, and associations: a systematic review and meta-analysis   (#260)

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: Fear of cancer recurrence (FCR) is reported by both cancer survivors and their caregivers, however, less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels and examine the strength of the relationship between them; (b) Quantify the proportion of caregivers who score above clinical cut-offs developed for survivors; (c) Examine the relationship between caregiver FCR and depression, and anxiety; (d) Evaluate the psychometric properties of caregiver FCR measures.

Methods: CINAHL, Embase, PsychINFO and PubMed databases were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/ or measurement, published in English-language, peer-review journals between 1997 and November 2022. The review was pre-registered with PROSPERO (ID: CRD42020201906).

Results: Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels that were as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between caregiver FCR and depression and anxiety, and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development steps and psychometric testing in caregiver populations. Only one instrument scored above 50% indicating substantial development or validation components were missing in most.

Conclusions: Results suggest that FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Measurement of caregiver FCR has predominately relied on survivor conceptualisation and unvalidated measures. Further caregiver specific FCR research is urgently needed.