Evaluation of fear of cancer recurrence after treatment in patients with aggressive lymphomas: a cross-sectional study

Background Fear of cancer recurrence (FCR) is a major psychological concern among cancer survivors, yet data remain limited among survivors of aggressive lymphomas (AgL). This study aimed to assess the prevalence and severity of FCR and to explore demographic and clinical factors associated with clinically significant FCR in patients with AgL who had completed treatment and achieved complete remission (CR). Methods We conducted a cross-sectional study in the Department of Clinical Hematology, Aziza Othmana Hospital, Tunis, Tunisia, among adult survivors of Hodgkin lymphoma or aggressive non-Hodgkin lymphoma who had completed treatment and achieved CR for at least 3 months. FCR was assessed using the 9-item Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF), with a score ≥22 defining clinically significant FCR in the present study. Sociodemographic and clinical characteristics were collected from medical records and patient questionnaires. Associations with clinically significant FCR were first explored using univariate analyses. Given the limited number of events, the multivariable logistic regression analysis was considered exploratory. Results Among 54 patients, the median age was 38 years and 29 (53.7%) were male. The median FCRI-SF score was 14 (range, 0–36). Clinically significant FCR was observed in 18 patients (33.3%). In univariate analyses, female sex, age <40 years, localized disease at diagnosis, and having children were associated with clinically significant FCR. Because only 18 events were observed, the multivariable logistic regression model was considered exploratory and effect estimates were unstable. Conclusion Clinically significant FCR was observed in approximately one-third of AgL survivors in CR. Younger age, female sex, localized disease at diagnosis, and having children were associated with higher FCR in univariate analyses. These findings should be considered hypothesis-generating and require confirmation in larger, multicenter studies using culturally and linguistically validated FCR assessment tools.