Promoting cancer screening for caregivers

A new study explores how the fear of cancer recurrence can motivate caregivers to undergo continued cancer screenings
cancer screening

Cancer patients, survivors, their family members and caregivers, all face the same uncertainty when it comes to cancer—whether the malignancy will return or progress.

What researchers call “fear of cancer recurrence,” or FCR, has been associated with feelings of depression and a poorer quality of life among those who have battled cancer. But FCR doesn’t only affect cancer patients. Family members and caregivers sometimes suffer more FCR-related anxiety, depression, and loneliness than their loved ones with cancer.

In a study published in the journal Cancer that provides the first evidence of the role FCR plays among caregivers over time, researchers at the University of Miami investigated the degree to which FCR predicts the cancer-screening behaviors of family caregivers—years after their relative’s initial cancer diagnosis. The researchers found that fear of recurrence motivates caregivers to undergo regular cancer screenings.

“Just the fear of cancer recurring or progressing for the patient is enough to make the caregiver pick up the phone and make the appointment for testing,” said principal investigator Youngmee Kim, a professor in the Department of Psychology.

The study found that the greater the caregivers’ FCR, the higher the chance that they’ll undergo tests for colorectal cancer and maintain and repeat prostate cancer screenings. Yet, the study found that caregivers’ FCR accounted for lower chances of maintaining age-appropriate breast cancer screenings. Moderate levels of FCR predicted a higher likelihood of maintaining age-appropriate colorectal cancer screening.

“Even if not biologically related, some family caregivers share the same environment and lifestyle as the cancer patients, so it is important to encourage engaging in proper cancer screening for the caregivers, too, not just for the cancer patient,” Kim added. “Another important message of this study is that today’s medical professions should channel caregivers’ FCR into a means to encourage proper cancer screening.”

For their study, the researchers analyzed the responses of 813 caregivers who completed the National Quality of Life Survey for Caregivers study two years and eight years after the cancer patient’s diagnosis. Psychological responses like FCR, anxiety, and mental health were reported in the two-year survey, and caregivers’ screening behaviors for colorectal, breast, and prostate cancers for the past 10 years were reported in the eight-year survey.

“We need to do better by expanding the attention from the cancer patient to their family members and caregivers by simply asking them what and how they are doing with their cancer-preventive behaviors,” Kim said. “Once we start that conversation, we can educate the family members and caregivers, and encourage them to make sure they are undergoing cancer screening. That’s what health professionals should be doing today.” 

Recently, the American Cancer Society reported that the cancer death rate in the United States fell 2.2 percent from 2016 to 2017. The research attributed the decline to reduced smoking rates and advanced treatments for lung cancer and melanoma. Yet, progress has slowed for colorectal, breast, and prostate cancers and, although the survival rate for all cancers has improved, cancer remains the second leading cause of death in the U.S.

In addition to Kim, the other UM researchers on the study include Emi Takeuchi, and Kim’s late husband and collaborator, Charles Carver; Rachel Cannady with the American Cancer Society, and Kelly Shaffer with the Center for Behavioral Health and Technology at the University of Virginia School of Medicine.