Assessing the relationship between fear of cancer recurrence and health care utilization in early-stage breast cancer survivors

purposethe purpose of this study was to determine whether fear of cancer recurrence (fcr) is associated with greater health care utilization (hcu) in early-stage breast cancer survivors. methods:three hundred early-stage breast cancer survivors diagnosed within the past 7 years reported on fcr as well as calls and visits to oncology providers and primary care providers during the preceding 3 months. participants also reported on use of mental health services and psychotropic medications since diagnosis. structural equation modeling was used to create a latent fcr factor and evaluate this factor as a predictor of various hcu outcomes controlling for age at diagnosis, years since diagnosis, generalized anxiety, objective risk of recurrence, and number of comorbidities. results:fcr predicted more visits to both oncology providers (rr = 1.53, p = .002) and primary care providers (rr = 1.31, p = .013), as well as more phone calls to oncology providers (rr = 2.08, p = .007). fcr was not a significant predictor of phone calls to primary care providers (rr = 1.39, p = .054), utilization of mental health treatment (or = 1.27, p = .362), or use of psychotropic medications (or = 1.37, p = .178). conclusion:sfcr was associated with increases in some types of hcu, which may reflect excessive medical reassurance-seeking and lead to unnecessary medical costs. implications for cancer survivorsfcr is a serious concern that warrants greater attention to reduce distress-related health care utilization. utilization of mental health services to address fcr may represent higher-value health care.