Factors Associated With Fear of Cancer Recurrence in Colorectal Cancer Patients: A Meta-analysis in Health Ecological Perspective

Background Fear of cancer recurrence is a major source of stress and unmet need for colorectal cancer patients. Objective This review aimed to identify factors influencing fear of cancer recurrence in colorectal cancer patients. Methods Multiple electronic databases were systematically searched for studies from inception to January 2024 using concepts “colorectal neoplasm,” “fear,” and “recurrence.” Two authors independently screened, assessed the quality of eligible studies, and extracted relevant data. The synthesis of effect sizes was conducted using R software version 4.3.1. Results A total of 20 studies were included, of which 11 were of moderate quality and 9 were of high quality. The studies reported on 22 potential influencing factors across 5 levels of the health ecological model, including innate personal traits, psychobehavioral factors, interpersonal network factors, living and working conditions, and policy environment factors. After synthesizing the data, it was found that all 22 factors were significantly associated with fear of cancer recurrence in colorectal cancer patients. Of these, 9 factors showed a moderate correlation with fear of cancer recurrence (0.3 < r ≤ 0.6), whereas 13 factors showed a lower level of correlation ( r ≤ 0.3). Conclusions The factors associated with the fear of cancer recurrence in colorectal cancer patients are complex and partially modifiable. Implications for Practice This study suggests that healthcare providers can use a health ecological perspective to provide interventions targeting these factors for colorectal cancer patients to effectively alleviate their fear of cancer recurrence and improve their quality of life.