Healthcare use and fear of recurrence in adult cancer survivors at 2.5 years after a cancer diagnosis: a nationwide register study in Denmark

PurposeTo investigate the association between fear of cancer recurrence (FCR) and healthcare use in general practice among cancer survivors.MethodsWe linked nationwide register data to survey data on FCR in cancer survivors at 2.5 years after a cancer diagnosis. Multiple regression models were used to analyse the association between high FCR level and quartiles of healthcare use at 18-30 months before the cancer diagnosis (habitual healthcare use) and between high FCR level and healthcare use at 18-30 months after the cancer diagnosis (survivorship healthcare use).ResultsWe included 1538 cancer survivors in the study. High habitual healthcare use was associated with a high level of FCR (odds ratio = 2.07 (95% confidence interval (CI): 1.36-3.15)) for the 4th quartile of healthcare use compared to the 1st quartile. A high FCR score was also associated with higher healthcare use during cancer survivorship (incidence rate ratio (IRR) = 1.26 (95% CI: 1.14-1.40)). This association remained statistically significant when adjusting for habitual healthcare use (IRR = 1.20 (95% CI: 1.09-1.33)).ConclusionHigh healthcare use before the cancer diagnosis was associated with high FCR during survivorship. This indicates that FCR is partly explained by a general (pre-diagnostic) health concern. High FCR predicted high healthcare use during cancer survivorship, even when adjusting for habitual healthcare use.Implications for Cancer SurvivorsOur results suggest that FCR in cancer survivors is triggered by a general high level of health concern, and the cancer diagnosis may further exacerbate this concern.

Automated summary

This study found a correlation between high fear of cancer recurrence (FCR) and high healthcare use among cancer survivors, especially when high healthcare use was already present before cancer diagnosis. High FCR predicted increased healthcare use during cancer survivorship, even after adjusting for habitual healthcare use.