Fear of Cancer Recurrence Among Uninsured and Underrepresented Men With Prostate Cancer

To characterize the prevalence of fear of cancer recurrence (FCR) and examine demographic, clinical, and psychosocial factors associated with high FCR among low-income, racially and ethnically diverse prostate cancer survivors treated with definitive therapy for localized disease.

We conducted a retrospective, cross-sectional analysis of 150 participants enrolled in the Men's Health Study (2001-2007) who completed the FCR Survey at baseline. High FCR was defined as a score ≤14 (lower tertile). Demographic, clinical, and patient-reported outcomes were assessed, including health-related quality of life (SF-12v2), prostate-specific quality of life (PCI-SF), symptom distress, spirituality, patient-physician interaction (PEPPI), and treatment regret.

High FCR was reported by 28% of participants. Sociodemographic and clinical variables-including age, race/ethnicity, treatment, clinical T stage, grade, PSA, and comorbidities-were not associated with FCR. High FCR correlated strongly with poorer mental health, lower SF-12 mental composite scores, and emotional limitations. Treatment regret was significantly more prevalent among those with high FCR (95.2% vs 28.7%, P<.001). Physical health and prostate-specific quality of life did not differ by FCR level.

Nearly one-third of uninsured, underrepresented prostate cancer survivors experienced high FCR, driven by emotional distress and decisional regret rather than objective clinical risk, underscoring the need for equitable, patient-centered survivorship care that supports psychological well-being and promoting patient informed decision-making.