Health anxiety in cancer patients in remission (V1) Ref: 14/SC/0073

  • Research type

    Research Study

  • Full title

    Predictors of health anxiety, quality of life and anxiety and depression in cancer patients in remission: A prospective study



  • Contact name

    Emily L Howe

  • Contact email

  • Sponsor organisation

    University of Bath

  • Research summary

    Predictors of health anxiety, quality of life and anxiety and depression in cancer patients in remission: A prospective study

    Research has shown that a significant proportion of cancer survivors have a range of unmet psychological needs. In the UK, a recent focus has been on the needs of cancer survivors. In 2010, the Department of Health launched an initiative aimed at improving service provision for people living with and beyond cancer.
    Anxiety is found to be elevated in cancer survivors compared to the normal population. A recent meta-analysis and systematic review found that anxiety, rather than depression was significantly higher in long-term cancer survivors compared to their spouses and healthy controls. They urged that research to improve recognition and treatment of anxiety in long term cancer survivors and their spouses is essential.

    One of the most common and distressing psychological needs is managing fear of cancer recurrence (FCR); defined as the fear that cancer will recur, progress or spread in the same or a different part of the body. It is considered to be a normal response to the possibility of recurrence following cancer, but can become persistent, predicting poorer quality of life 6 years post-diagnosis. Furthermore, in some cases FCR may maintain unhelpful avoidance behaviour, hypervigilance for symptoms of recurrence and an inability to plan for the future. At the higher end of the spectrum, patients may develop high levels of health anxiety that impacts on their functioning. Research has investigated psychological factors associated with elevated FCR such as depression. Cognitive-behavioural therapy for reducing FCR has been shown to be effective. However, little research has investigated specific psychological predictors of elevated health anxiety and other psychological outcomes (i.e. quality of life, depression and anxiety).

    This study will look at whether (a) mental defeat (b) existential concerns (c) beliefs about emotions(d) intolerance of uncertainty predict levels of (e) health anxiety (pre-occupancy and worry that one has a serious illness), (f) quality of life and (g) depression and anxiety in cancer patients who are in remission (i.e. have completed treatment that has cured the disease).

    Patients who are in receipt of follow-up care from the Great Western Hospital, Swindon or Salisbury District Hospital will be invited to complete two sets of questionnaires 4 weeks apart which measure the factors outlined above. We will also ask their age, sex, type of cancer, type of treatment, amount of time since ending treatment, and dates of their previous and next follow up appointment with their Consultant.

    We will then use the information gathered to test whether;

    (a) mental defeat (b) existential concerns (c) beliefs about emotions (acceptability of experiencing and expressing emotions)(d) and intolerance of uncertainty

    relate to or

    predict levels of:

    (e) health anxiety (f) quality of life and (g) depression in cancer patients in remission.

    This research will help to identify factors that predict poorer psychological outcomes (i.e. health anxiety, depression and anxiety, poor quality of life). This is a preliminary study which will inform future research on early detection and treatment of psychological problems in cancer patients in remission.

  • REC name

    North East - Newcastle & North Tyneside 1 Research Ethics Committee

  • REC reference


  • Date of REC Opinion

    31 Jan 2014

  • REC opinion

    Favourable Opinion