Impact of fear of cancer recurrence on survival among lymphoma patients

Seok Jin Kim, Danbee Kang, Im Ryung Kim, Sang Eun Yoon, Won Seog Kim, Phyllis N. Butow, Eliseo Guallar, Juhee Cho

Research output: Contribution to journalArticlepeer-review


Objective: This study aimed to evaluate fear of cancer recurrence (FCR) among lymphoma patients who completed treatment and its impact on survival and quality of life (QOL). Methods: In this prospective cohort study, 467 lymphoma patients were included who completed treatment with curative intent between February 2012 and March 2017. FCR was measured using a question from the Korean version of the QOL in Cancer Survivors Questionnaire. QOL and general health and functioning were measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. Participants were actively followed up for all-cause and disease-specific mortality. Results: In total, 16.3% of the patients had severe FCR. The adjusted hazard ratio (HR) for all-cause mortality comparing participants with and without severe FCR was 2.52 (95% CI = 1.15-5.54), and the association was stronger in indolent non-Hodgkin lymphoma (NHL) (HR = 6.77; 95% CI = 1.04-43.92). Participants with severe FCR were also at higher risk of lymphoma-specific mortality (HR = 2.62; 95% CI = 1.13-6.05) than patients without severe FCR. Patients with severe FCR had significantly worse general health status (64.3 vs 71.0, P =.03) and physical (82.4 vs 76.7, P <.01), emotional (68.5 vs 84.8, P <.001), and social functioning (67.8 vs 84.2, P <.001) than patients without severe FCR. Conclusions: A substantial number of participants with lymphoma experience FCR after treatment completion, even in the case of indolent lymphomas. Given the negative impact of severe FCR on survival and general health and functional status, active monitoring and appropriate management of FCR should be considered in clinical settings.

Original languageEnglish (US)
Pages (from-to)364-372
Number of pages9
Issue number2
StatePublished - Feb 1 2020
Externally publishedYes


  • fear of cancer recurrence
  • lymphoma
  • survival

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health


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