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E-Health Intervention for Fear of Cancer Recurrence: A Randomized Clinical Trial
Johanne Dam Lyhne1,2, Allan Ben Smith3,4, Signe Timm1,2
1Department of Clinical Oncology, University Hospital of Southern Denmark, Vejle, Denmark.
JAMA Network Open
|November 11, 2025
Summary
Fear of cancer recurrence (FCR) significantly decreased in colorectal cancer survivors using the therapist-guided e-health program TG-iConquerFear. This online intervention offers a promising, accessible option for managing FCR post-treatment.
Area of Science:
- Oncology
- Psychology
- Digital Health
Background:
- Fear of cancer recurrence (FCR) is a significant concern for cancer survivors, impacting quality of life.
- Effective interventions are needed to address FCR, balancing accessibility with clinical efficacy.
- E-health interventions offer a scalable solution for managing psychological distress in cancer survivors.
Purpose of the Study:
- To evaluate the efficacy of the 10-week therapist-guided (TG) e-health intervention, TG-iConquerFear, in reducing FCR among colorectal cancer (CRC) survivors.
- To assess the impact of an accessible online program on psychological well-being in cancer survivors.
- To determine if an e-health approach can provide a clinically meaningful reduction in FCR.
Main Methods:
- A randomized clinical trial involving cancer-free adult CRC survivors with clinically significant FCR (FCRI-SF score ≥22).
- Participants were randomized (1:1) to either the TG-iConquerFear intervention or an augmented control group.
- The TG-iConquerFear intervention consisted of 6 modules with asynchronous therapist guidance over 10 weeks.
Main Results:
- The TG-iConquerFear group showed a significant reduction in FCR total score at 3 months postintervention (mean change -21.7 points) compared to the control group (mean change -2.6 points).
- A significantly higher proportion of participants in the TG-iConquerFear group achieved FCR scores below the clinical cutoff at 3 months (81% vs 43%).
- The intervention demonstrated a statistically significant between-group difference (19.1 points, P < .001) with a moderate effect size (Cohen d = 0.62).
Conclusions:
- The therapist-guided e-health intervention, TG-iConquerFear, significantly reduced fear of cancer recurrence in CRC survivors.
- This study suggests that e-health interventions can effectively expand treatment options for FCR beyond traditional face-to-face approaches.
- TG-iConquerFear represents a viable and effective digital tool for managing psychological distress in cancer survivors.
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