Evaluating Tools for Assessing Fear of Cancer Recurrence in Adults for Nursing Practice: A Systematic Review

To identify, assess and compare internationally validated tools that measure the fear of recurrence in adult survivors of cancer.

This systematic review was based on the PRISMA reporting guidelines and COSMIN methodology was applied to analyses the psychometric properties and the validation process of the selected assessment tools. The search was conducted on 6 databases: PubMed/Medline, Cochrane Library, CINAHL, Web of Science, Scopus and LILACS, from 2001 to 2023. The descriptors used were: "fear of cancer recurrence," "tools," "validity," "reliability" and "cancer survivors." Studies focused on the design, validation or cultural adaptation of fear of cancer recurrence tools in adult cancer patients were selected. The COSMIN checklist was used to compare the tools measurement properties, including the following dimensions: conceptual suitability, applicability and psychometric features, and also to assess the methodological quality and the risk of bias of the different studies.

18 studies have been included. Three validated tools were identified for measuring fear of cancer recurrence in adults: CARS, FCRI and FCR7, which were also adapted in various languages. Although there are differences in the validation process, most of the tools were validated with acceptable psychometric properties and with a suitable cultural adaptation.

The 3 main tools identified are valid to measure fear for cancer recurrence although vary on their level of development, being FCR4/7 the most recent and consistent 1. Despite the availability of these tools, there is a lack of validated instruments in Spanish-speaking contexts. Regular use of these tools in Nursing practice would contribute to early detect fear of cancer recurrence and to effectively manage it, improving the quality of life of cancer patients. Recently, shorter versions have arisen to facilitate its applicability.