Comparative Efficacy of Psychosocial Interventions on Fear of Cancer Recurrence: A Network Meta-Analysis

Many cancer survivors experience distress due to the fear of cancer recurrence (FCR). While psychosocial interventions are increasingly used to address FCR, the optimal choices remain unclear.

To compare and rank the effectiveness of psychosocial interventions for the FCR in cancer survivors.

We performed a systematic review and network meta-analysis. A thorough electronic literature search was conducted in 8 databases to identify relevant randomized controlled trials published until January 2024. A random-effects model was employed for the traditional meta-analysis. Network meta-analysis was utilized to assess the relative effects and ranking probabilities of these interventions. The protocol was preregistered with the PROSPERO database (registration no.: CRD42023438417).

A total of 41 randomized controlled trials were included in this network meta-analysis involving 8 different psychosocial interventions. Traditional cognitive behavioral therapy (CBT) and contemporary CBT were significantly more effective than the control groups. Rankings probabilities indicated that traditional CBT, contemporary CBT, self-guided internet-based CBT, supportive therapy, and technician-guided internet-based CBT might be the top 5 most effective interventions for FCR.

Our study confirmed the efficacy of several psychosocial interventions for FCR in cancer survivors, with traditional CBT being potentially the most effective intervention for FCR.

These findings hold implications for guiding future guidelines and clinical decisions, aiding in the recommendation of interventions to alleviate FCR during routine care.