Fear of Progression in Pediatric Cancer Patients and Their Parents: Trajectories, Prevalence, and Correlates Across Acute Treatment and Follow-Up Care
Menée en Allemagne par questionnaire auprès de 171 dyades parent-enfant atteint d'un cancer (âge des patients pédiatriques : 7-18 ans), cette étude transversale identifie des facteurs associés à la peur de la progression de la maladie
Purpose: Fear of progression (FoP) represents a significant psychological burden for pediatric cancer patients and their parents. This study investigates FoP levels across acute treatment (AcT) and follow-up care (FuC) and examines trajectories over time, associated sociodemographic factors, and parent-child associations. It also proposes clinically relevant thresholds for psychosocial care.
Methods: A total of 171 patient–parent dyads participated in a cross-sectional and longitudinal study. Children aged 7–18 and one parent per child completed the Fear of Progression Questionnaire—Short Form (FoP-Q-SF). Data were collected during AcT (two time points) and FuC. Statistical analyses included nonparametric tests and correlation analyses.
Results: FoP levels were significantly lower during FuC compared to AcT for both children and parents, and parental FoP decreased over the 1-year follow-up period. Parents consistently showed higher FoP than their children, and a significant parent–child correlation emerged in FuC. FoP was higher in girls and was positively associated with child age and negatively associated with parent age. Using suggested thresholds, 57.8% of parents showed dysfunctional FoP. Among children, 45.2% reported low, 40% moderate, and 14.8% high FoP.
Conclusion: Although levels of FoP are lower in FuC than in AcT, they remain a prevalent burden—particularly for younger parents, older children, and girls. The observed parent-child associations highlight the need for family-oriented psychosocial care. A proposed three-stage cut-off (low, moderate, high FoP) may guide clinical decision-making and support tailored treatment strategies. Routine screening and preventive approaches are recommended to mitigate FoP and its potential intergenerational transmission.
Trial Registration: The study has been pre-registered at the German Clinical Trials Register (DRKS 00022034, registered 29th of June 2020) and at the Open Science Foundation (https://osf.io/fuahc).
Psycho-Oncology , résumé, 2026