Fear of Cancer Recurrence Prevalence and Its Associated Factors Among Family Caregivers of Women With Breast Cancer: A Systematic Review and Meta-Analysis.

Abstract

<h4>Background</h4>The fear of cancer recurrence (FCR) levels reported by caregivers are as high as those reported by women with breast cancer, with some caregivers even reporting FCR levels higher than women with breast cancer. The recognition of factors associated with caregiver FCR is important for providing proactive support to caregivers at risk.<h4>Objective</h4>To identify factors associated with high FCR in caregivers of women with breast cancer.<h4>Methods</h4>A systematic search of eight electronic databases was conducted from database inception to August 2023. The identified papers were screened, and their full texts were further assessed. The quality of the included studies was examined by using a checklist, and relevant data were extracted with a predeveloped data extraction form. The best-evidence synthesis model was used for data synthesis. Meta-analysis was conducted to calculate the prevalence of caregiver FCR.<h4>Results</h4>The search yielded a total of 2137 studies, and 15 studies involving 2461 caregivers were included after the screening and full assessment of 56 papers. A total of 29 factors were identified. Of these factors, five factors with a moderate level of evidence associated with high FCR were identified: insufficient communication of women with breast cancer, low level of resilience, high social constraints, high protective buffering and insufficient communication of caregivers; 15 associated factors were supported by limited-level evidence and nine were supported by conflicting-level evidence. The prevalence of FCR in caregivers was 45%.<h4>Conclusions</h4>The associated factors examined provide some evidence for identifying caregivers who are at high risk of high FCR. Identifying factors contributing to FCR in caregivers is important for developing interventions for those caregivers most in need and reducing adverse health outcomes related to caregiver FCR. Additional studies are needed to examine the relationship between conflicting factors and caregiver FCR.<h4>Patient or public contribution</h4>No patient or public contribution.<h4>Trial registration</h4>PROSPERO registration number: CRD42023469754; identifier: https://www.crd.york.ac.uk/PROSPERO/#recordDetails.