The interconnectedness of fear of cancer recurrence components: A network approach.

Objective: While nearly 60% of cancer survivors report a heightened fear of cancer recurrence (FCR), not all of them experience functional impairment and want professional psychological care. We applied the network approach to study how different components of FCR (symptoms, triggers, perceived risk, and coping strategies) are interconnected to both FCR severity and functional impairment to better understand which survivors are likely to require psychological care.

Methods: We applied network analysis to cross-sectional data from 3,370 cancer survivors from nine different countries, spanning Asia, Australia, Europe, and North America, from the international Fear of Cancer Recurrence Inventory database. The shortest path analysis was applied to study what components were directly connected to both FCR severity and functional impairment.

Results: FCR severity was mainly connected to symptoms and triggers while functional impairment was mainly connected to coping strategies. The shortest paths indicated that worry and bodily triggers were directly connected to both higher FCR severity and more functional impairment.

Conclusions: Worry and bodily triggers appear to be core components of FCR that are experienced as impairing in daily life. Our findings suggest that assessing functional impairment, worry, and bodily triggers, in addition to FCR severity, could be valuable when screening for clinical levels of FCR. To further improve our conceptual understanding of FCR, future studies should apply intensive longitudinal designs to explore how these components interact over time and within the individual. (PsycInfo Database Record (c) 2025 APA, all rights reserved).