A single item screening question for fear of recurrence in head and neck cancer

Abstract

Background: Fear of recurrence (FoR) is the most frequent concern patients wish to discuss in head and neck review clinics. Aim: To design a simple screening question on fear of recurrence to be incorporated into the University of Washington Quality of Life Questionnaire (UW-QOLv4), for use in clinical practice. Methods: A cross-sectional survey comprising 528 patients. Results: 11% selected the two most severe FoR categories. FoR responses correlated strongly (Spearman rs=-0.82) with the mean score of the 7 items of the Fear of Recurrence Questionnaire. There was also a strong association with anxiety and mood dysfunction as measured from the UW-QOL, and with overall QOL. Patients more affected by FoR tended to be younger and post radiotherapy or chemotherapy. Conclusion: The FoR screening question should be bolted on to the UW-QOLv4 in order to help identify patients with significant FoR might benefit from further intervention.