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Cognitive–behavioural therapy effectiveness for fear of cancer recurrence: systematic review and meta-analysis
  1. Fangxin Wei1,
  2. Ruiyao He1,
  3. Xin Yang1,
  4. Ziqi Hu1 and
  5. Yu Wang2
  1. 1School of Nursing, Jinan University, Guangzhou, Guangdong, China
  2. 2Jinan University First Affiliated Hospital, Guangzhou, Guangdong, China
  1. Correspondence to Dr Yu Wang, Jinan University First Affiliated Hospital, Guangzhou, Guangdong 510632, China; hulibuwangyu{at}126.com

Abstract

Objective Fear of cancer recurrence is one of the psychological distresses for patients with cancer and cancer survivors, which poses a physical and psychological threat. There is scant evidence on the effectiveness of cognitive–behavioural therapy in reducing fear of cancer recurrence. Therefore, we conducted a systematic review and meta-analysis to assess the effectiveness of cognitive–behavioural therapy for fear of cancer recurrence.

Method The review was reported according to Preferred Reporting Items for Systematic Review and Meta-analyses statement. Seven databases were systematically searched from inception to 31 March 2023. Randomised controlled trials implementing cognitive–behavioural therapy interventions and studies reporting fear of cancer recurrence were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool 2.

Results A total of 32 randomised controlled trials involving 1515 cancer survivors and 1845 patients with cancer undergoing treatment were included. The meta-analysis indicated a significant effect of cognitive–behavioural therapy on fear of cancer recurrence in patients with cancer and cancer survivors compared with controls (g=−0.65; 95% CI=−0.86, –0.44; p<0.001). The results of the overall risk of bias indicated some concerns in 4 studies and a high risk in 28 studies.

Conclusion The study indicated the effectiveness of cognitive–behavioural therapy intervention for fear of cancer recurrence in patients with cancer and cancer survivors, which should inform future clinical practice of interventions for the treatment of fear of cancer recurrence.

PROSPERO registration number CRD42023404948.

  • Cancer

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • FW and RH contributed equally.

  • Contributors FW was responsible for the conception and design of this study. FW and RH performed the search and evaluated studies for inclusion. FW and RH extracted data from selected RCTs. FW and RH assessed the quality of selected RCTs. XY and ZH assessed the quality of certainty of the evidence. FW and XY performed data analysis. FW and YW reviewed the work. FW and RH drafted the paper. Revising the manuscript critically for important intellectual content: YW. Approval of the version of the manuscript to be published: YW.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.