Fear of cancer recurrence in breast cancer: A moderated serial mediation analysis of a prospective international study.

Women dealing with breast cancer (BC) face many challenges, one of which is the fear of cancer recurrence (FCR). This study examined whether disease severity predicts FCR 6 months after cancer diagnosis through psychological distress and whether cognitive-emotion regulation moderates this effect. The study sample included 656 women from Italy (27.5%), Finland (31.9%), Israel (19.8%), and Portugal (20.8%) diagnosed with Stages I-III of BC. Participants' age ranged between 40 and 70 years ( Greater disease severity at baseline indicated by higher cancer stage predicted greater psychological distress, which in turn predicted greater psychological distress at 3 months. The latter predicted greater FCR at 6 months. This serial mediation model was moderated by negative cognitive-emotion regulation. The mediating effect of disease severity on FCR through psychological distress was significant only in women with mean or higher levels of negative cognitive-emotion regulation. This study suggests that facilitating psychological well-being and effective cognitive-emotion regulation in the early stages after a cancer diagnosis may protect women from FCR. (PsycInfo Database Record (c) 2024 APA, all rights reserved).