Abstract
OBJECTIVE: To investigate the level of fear of cancer recurrence (FCR) in bladder cancer patients across different age groups and to identify associated sociodemographic, clinical, and psychosocial factors. This study aims to provide an evidence base for developing age-specific psychological interventions. METHODS: A cross-sectional survey was conducted among 322 bladder cancer patients primarily diagnosed with non-muscle invasive bladder cancer (NMIBC) at Hebei General Hospital between January 2020 and December 2022. Patients were categorized into a younger group (18-59 years) and an older group (≥60 years). Data were collected using a general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Social Support Rating Scale (SSRS), and the Simplified Coping Style Questionnaire (SCSQ). Descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple linear regression analyses were performed. RESULTS: The mean FCR scores were significantly higher in the younger group (33.46 ± 7.62) compared to the older group (28.93 ± 8.58) (P<0.001). Multiple linear regression analysis (R²=0.500, F=31.075, P<0.001) identified several significant predictors of FCR: younger age (β=-0.100, P=0.022), lower per capita monthly family income (β=-0.171, P<0.001), advanced tumor TNM stage (β=0.207, P<0.001), poorer doctor-patient communication (β=0.112 for "General" vs "Very Satisfied", P=0.013), more tumor recurrences (β=0.100, P=0.023), less use of positive coping strategies (β=-0.100, P=0.029), more use of negative coping strategies (β=0.241, P<0.001), and lower social support (β=-0.232, P<0.001). CONCLUSION: Bladder cancer patients experience considerable FCR, with younger patients exhibiting significantly higher levels than older patients. Factors such as age, socioeconomic status, disease severity, communication, coping styles, and social support are crucial determinants of FCR. Early identification of these factors and the implementation of tailored, age-appropriate interventions are recommended to alleviate FCR in this population.