Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

The effect of metacognition-based, manualized intervention on fear of cancer recurrence: a randomized controlled trial (#536)

Wendy Wing Tak Lam 1 2 , Danielle Ng 1 2 , Richard Fielding 1 2 , Rachel Ng 1 2 , Ceci Guo 1 2 , Ava Kwong 3 , Dominic Chi-Chung Foo 3
  1. LKS Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong, China
  2. Centre for Psycho-onoclogy Research and Training, School of Public Health, The University of Hong Kong, Hong Kong
  3. Department of Surgery, HKU, Hong Kong

Purpose

This randomized controlled trial (RCT) assessed the effectiveness of a culturally adapted metacognition-based manualized intervention (ConquerFear) in managing fear of cancer recurrence (FCR) among Hong Kong Chinese cancer survivors.

 

Methods

Chinese cancer survivors who had completed primary and adjuvant treatments within 2 years  with an FCRI-SF cutoff score > 13 were recruited in the study. Participants were randomly allocated to  either the intervention arm (ConquerFear-HK; focusing on attention training, metacognition modification, acceptance, appropriate monitoring behaviour, and goal settings) or the active control arm (BasicCancerCare; standardised survivorship care), with 6 sessions each. Participants were assessed at prior randomization (baseline; T0), immediately post-intervention (T1), 3-month (T2), and 6-month (T3) post-intervention using the Fear of Cancer Recurrence Inventory (FCRI), metacognition (MCQ-30), and sociodemographic information. Clinical details were extracted from medical records. T-test and linear mixed model analyses were performed to compare outcome changes over time.

 

Results

Of the 223/845 eligible patients approached, 178 (79.8%) consented, with 90 randomised to the intervention arm and 88 randomised to the control arm. A total of 79.8% of participants completed at least one follow-up assessment and were included in the final analysis (n=142). The total FCRI score change between T2 and T0 differed significantly between the intervention groups (intervention: mean=-15.17 vs. control: mean=-7.06; p=0.021). There were significant declining trends in FCR (p<0.001) and negative MCQ in both arms (p=0.002), with a faster rate of decline observed in the intervention arm than in the control arm (FCR: p=0.009; negative MCQ: p=0.005). The change in the negative MCQ score was unrelated to the change in FCR over time.

 

Conclusion

ConquerFear-HK is effective in managing FCR in the short term (i.e., 3-month post-intervention). An additional booster session may be considered for the intervention to further enhance its long-term effects. The mechanism underlying ConquerFear-HK remains unclear and warrants further investigation.