Representations of cancer recurrence risk, recurrence worry, and health-protective behaviours: an elaborated, systematic review

ABSTRACT

An expanded Common-Sense Model (CSM) contextualised to the self-regulation of cancer recurrence risk identifies risk representational attributes and recurrence worry as primary processes motivating protective behaviours in cancer survivors. A systematic review examined evidence for CSM hypotheses regarding how these processes influence diet and physical activity (PA) among survivors. A research agenda is outlined and used to evaluate the evidence base. Common databases were searched for eligible, peer-reviewed, English language reports, yielding 18 studies quantitatively testing hypothesised relationships among representations of prior cancer, recurrence risk representations, recurrence worry, and diet and PA. The findings provide promising, but mixed and limited evidence for some of the hypothesised associations of specific risk recurrence attributes with recurrence worry, and risk recurrence attributes and recurrence worry with diet and PA. Findings support the distinction of recurrence risk representations and illness representations of the prior cancer, with each showing different relationships with recurrence worry and behaviours. We discuss the status of the evidence base in relation to assessment, design, and analysis priorities and propose strategies that can yield more sensitive, rigorous tests of the CSM for cancer recurrence risk as applied to diet and PA.

KEYWORDS:

• Self-regulation model
• cancer recurrence beliefs
• illness representations
• cancer recurrence worry
• risk perception
• diet and physical activity

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Arturo Durazo http://orcid.org/0000-0003-1373-1446

Linda D. Cameron http://orcid.org/0000-0003-1874-3526

Notes

1 Errors appear in Freeman-Gibb et al. (2017, pp. 1272–1274) for references to consequences and control/cure attributes. In Measures, there are erroneous references to personal consequences and treatment consequences subscale. In the tables, statistics labelled ‘personal consequences’ are actually those for ‘personal control’ and statistics labelled ‘treatment consequences’ are those for ‘treatment control’.