Background: The guideline makes recommendations based on evidence-based strategies and/or interventions to screen, assess, and manage fear of cancer recurrence (FCR) in adults living with cancer and their care partners to improve patient outcomes.
Methods: The Fear of Cancer Recurrence Guideline Working Group, composed of clinical psychologists, nurses, researchers, and patient representatives was convened at the request of Ontario Health Psychosocial Oncology Program. The Group worked from November 2021 to January 2024 with the Program in Evidence-Based Care to produce evidence-based and evidence-informed guidance documents. The process included a systematic review, interpretation of the evidence by the Working Group and draft recommendations, internal review by content and methodology experts and external review by Ontario clinicians and other stakeholders.
Impact on practice: Based on the reviewed evidence, we recommended that adults living with cancer complete at each clinical encounter a single-item screener, the FCR-1r, because it can be added into the ESAS, which is currently administered across cancer centers in Ontario. We recommend that those identified as scoring 5 and more on the FCR-1r complete a standardized FCR measure. We propose a matched care approach for interventions based on level of FCR (low, moderate, and high), starting with psychoeducation for all and reserving FCR-specific CBT of mind-body interventions for those with high FCR. More research is needed to strengthen recommendations for care partners.
Discussion: The guideline focuses on recommendations that can be implemented in cancer centers with relative ease and that make use of existing resources.