# Fear of Cancer Recurrence Among Parents of Children with Cancer Who Underwent Germline Genetic Testing

## TL;DR

Parents of children with cancer experience significant fear of recurrence, influenced by factors like child's age, cancer type, and parent background.

## Contribution

Quantifies fear of cancer recurrence in parents of childhood cancer survivors and identifies associated demographic and clinical factors.

## Key findings

- 42.2% of parents reported fear of recurrence scores above 22.
- Fear of recurrence was higher in parents of children with central nervous system tumors or hematological malignancies.
- Parental fear of recurrence varied by race, education, and spirituality.

## Abstract

Fear of cancer recurrence is a common mental health concern among caregivers of adults with cancer, yet its prevalence and risk factors among parents of children treated for cancer are unclear. In this study, parents of children treated for cancer completed a questionnaire assessing fear of their child’s cancer recurrence. Results showed parental fear of recurrence levels similar to caregivers of adults with cancer. Fear of recurrence was associated with child age, cancer type, and time since diagnosis and treatment completion, as well as parent race, education, and spirituality. These findings suggest subgroups of parents who may be at higher risk for experiencing fear of recurrence. These results suggest that fear of recurrence may be a psychosocial need for parents of children with cancer following cancer-directed treatment. Future research should develop and validate fear of recurrence screening measures for parents, with mental health resources tailored to address these concerns.

Fear of cancer recurrence (FCR) is a significant but understudied concern among parents of childhood cancer survivors. This study quantitatively characterized parental FCR and explored potential demographic and clinical correlates among parents of children treated for cancer. Parents (N = 192) completed the Fear of Cancer Recurrence Inventory-Parent Short Form (FCRI-Parent) and provided demographic information. Clinical variables were obtained from medical chart review. Associations between FCR and demographic or clinical variables were analyzed using t-tests, ANOVAs, and Pearson’s correlations. Parents reported a mean FCR score of 18.64 (SD = 8.73), with 42.2% of parents endorsing FCR above a score of 22. Parental FCR significantly varied by parent race, education, and spirituality. Higher FCR was also significantly negatively correlated with child age, time since diagnosis, and time since treatment completion. Parents of children with central nervous system tumors or hematological malignancies endorsed significantly higher FCR compared to parents of children with solid tumors. Findings build on previously identified psychosocial needs for parents of children treated for cancer by quantitatively describing parental FCR and exploring subgroups that may be at increased risk for FCR. Tailored interventions, including strategies that support spiritual coping, may help mitigate FCR among at-risk parents.