High fear of cancer recurrence in Chinese newly diagnosed cancer patients

Authors thank the President Foundation of Nanfang Hospital, Southern Medical University (2007L001), and the Guangzhou Science and Technology Project (201804010132) for funding the study.Background: Fear of cancer recurrence (FCR) is common among cancer patients and of high clinical relevance. This study explores the prevalence and correlates of FCR in Chinese newly diagnosed cancer population. Methods: This is a multicentre, cross-sectional study that includes 996 patients with mixed cancer diagnosis. All recently diagnosed patients completed a questionnaire consisting of the following: Fear of Progression Questionnaire-Short Form (FoP-Q-SF), General Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire (PHQ-9). Univariate analyses, multivariate logistic regression analyses, and structural equation modeling (SEM) was performed to examine the association between tested variables and FCR. Results: Of the 996 patients, 643 (64.6%) reported high FCR (scored ≥ 34 in the FoP-Q-SF). Chemotherapy (OR = 1.941), Childhood severe illness experience (OR = 2.802), depressive (OR = 1.153), and anxiety (OR = 1.249) symptoms were positively associated with high FCR, while higher monthly income (OR = 0.592) was negatively associated with high FCR. SEM indicated that emotional disturbances (anxiety and depression) directly influenced FCR, while emotional disturbances partly mediated the association between personal monthly income and FCR. Conclusion: High FCR is a frequently reported problem among newly diagnosed cancer patients. Various factors increased the likelihood of the development of FCR. Flexible psychological interventions are needed for patients with high FCR.Publisher PDFPeer reviewe

Psychometric properties of the Chinese version Fear of Cancer Recurrence Questionnaire-7 (FCR-7)

Funding: President Foundation of Nanfang Hospital, Southern Medical University (2017L001); Guangzhou Science and Technology Project (201804010132); Key Item of Guangzhou bureau of education (2019KC106), and Innovation Item of Guangdong Provincial Department of Education (2018A043442).This article investigates the reliability and validity of the Chinese version of the 7-item Fear of Cancer Recurrence Questionnaire (FCR-7). A total of 1,025 cancer patients were recruited and asked to complete the Chinese FCR-7, Fear of Progression Questionnaire—Short Form (FoP-Q–SF), 9-item Patient Health Questionnaire (PHQ-9), and 7-item General Anxiety Disorder Questionnaire (GAD-7). The internal consistency and test–retest reliabilities were examined. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted on random split-half samples. Overall relationships of FCR-7 with other psychological constructs were examined. The Chinese FCR-7 showed good internal consistency (Cronbach’s alpha = .87), test–retest reliability (r = .90), and item–total correlations (range = .583–.872). The unitary factor structure was supported by the EFA and the CFA fit statistics (comparative fit index = .99, root-mean-square error of approximation = .039, 95% confidence interval [.01, .07]). The total score of FCR-7 was positively associated with FoP-Q–SF (r = .756, p < .01), PHQ-9 (r = .522, p < .01), and GAD-7 (r = .553, p < .01). Patients with low monthly income (p < .001) and family cancer history (p = .012) and those who had gone through chemotherapy (p = .001) tended to report higher fear of cancer recurrence (FCR). The FCR-7 has been translated and successfully culturally adapted into a Chinese version. It is a reliable and valid measurement for assessing FCR.PostprintPeer reviewe

Anti-Toxoplasma gondii antibodies as a risk factor for the prevalence and severity of systemic lupus erythematosus

Abstract Background Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease characterized by the presence of numerous autoantibodies. The interaction of infectious agents (viruses, bacteria and parasites) and a genetically susceptible host may be a key mechanism for SLE. Toxoplasma gondii is a widespread intracellular parasite that has been implicated in the pathogenesis of autoimmune diseases. However, the relationship between T. gondii infection and the increased risk of SLE in Chinese populations remains unclear. Methods The seroprevalence of T. gondii infection was assessed in 1771 serum samples collected from Chinese individuals (908 healthy controls and 863 SLE patients) from different regions of China using an enzyme-linked immunosorbent assay. Serum autoantibodies and clinical information were obtained and analysed. Results Our observations revealed a higher prevalence of anti-T. gondii antibodies (ATxA) immunoglobulin G (IgG) in serum samples from SLE patients (144/863, 16.7%) than in those from the healthy controls (53/917, 5.8%; P < 0.0001), indicating a 2.48-fold increased risk of SLE in the ATxA-IgG+ population, after adjustment for age and sex (95% confidence interval [CI] 1.70–3.62, P < 0.0001). ATxA-IgG+ SLE patients also showed a 1.75-fold higher risk of developing moderate and severe lupus symptoms (95% CI 1.14–2.70, P = 0.011) compared to ATxA-IgG− patients. Relative to ATxA-IgG− patients, ATxA-IgG+ patients were more likely to develop specific clinical symptoms, including discoid rash, oral ulcer, myalgia and alopecia. Seven antibodies, namely anti-ribosomal RNA protein (rRNP), anti-double stranded DNA (dsDNA), anti-cell membrane DNA (cmDNA), anti-scleroderma-70 (Scl-70), anti-cardiolipin (CL), anti-beta2-glycoprotein-I (B2GPI) and rheumatoid factor (RF), occurred more frequently in ATxA-IgG+ patients. When combined with anti-dsDNA and RF/anti-rRNP/anti-cmDNA/ESR, ATxA-IgG significantly increased the risk for severe lupus. Conclusions Our results suggest that ATxA-IgG may be a significant risk factor for SLE prevalence and severity in Chinese populations. Graphical Abstrac