Fear of cancer recurrence in young early-stage breast cancer survivors: the role of metacognitive style and disease-related factors


Correspondence to: Centre for Medical Psychology and Evidence-Based Decision Making, School of Psychology, University of Sydney, Sydney, NSW, Australia. E-mail: bthewes@usyd.edu.au



Fear of cancer recurrence (FCR) is a common challenge of cancer survivorship, particularly in younger survivors. Maladaptive metacognitions have been shown to be important to the development of a range of emotional disorders but have not previously been explored in the context of FCR.


This study aimed to explore the relationship between FCR and a maladaptive metacognitions.


This cross-sectional study included young women diagnosed with early-stage breast cancer at least 1 year prior to study entry. Participants completed a web-based questionnaire, which included the Fear of Cancer Recurrence Inventory (FCRI) and the brief Metacognitions Questionnaire-30 (MCQ-30). Linear regression was used to calculate unadjusted and adjusted slope estimates of the association of FCR with six metacognition variables, the total score of the MCQ-30 and the five subscales.


Two-hundred and eighteen women with a mean age of 39 years at diagnosis participated. All measures of metacognitive style were moderately correlated with FCRI scores (r = 0.31–0.49) and significantly associated with FCRI in both unadjusted and adjusted models. Overall metacognitive style explained 36% of the variance in FCR scores in combination with disease and demographic factors. Negative metacognitions (R2 = 0.32) and need for control over cognition (R2 = 0.26) were the MCQ-30 subscales most associated with higher FCR.


Unhelpful metacognitions appear to play an important role in FCR in young women with early-stage breast cancer. Treatments that focus on changing unhelpful metacognitions may prove a useful approach for treating clinical FCR in cancer survivors in the future. Copyright © 2013 John Wiley & Sons, Ltd.