The association between education and fear of recurrence among breast cancer patients in follow-up – and the mediating effect of self-efficacy

Figures & data

Table 1. Descriptive sociodemographic characteristics among 917 women in follow-up after breast cancer who had follow-up changed from oncologist-led to nurse-led or patient-initiated follow-up, Region Zealand, Denmark, 2016–17.

	Total (n = 917) N (%)	Education
		Short (n = 273)	Medium (n = 192)	Long (n = 452)
Age
Mean (SD)	67.6 (9.4)	70.8 (8.9)	67.6 (9.6)	65.7 (9.1)
Cohabitation status
Living with a partner	609 (66)	161 (59)	131 (68)	317 (70)
Living alone	308 (34)	112 (41)	61 (32)	135 (30)
Time since diagnosis (years)*
Mean (SD)	6.1 (3.2)	6.2 (3.4)	6.1 (2.8)	6.1 (3.2)
≤5 years	366 (40)	105 (38)	71 (37)	190 (42)
>5 years	543 (59)	165 (60)	118 (61)	260 (58)
Tumor size
0–20 mm	580 (63)	169 (62)	120 (63)	291 (64)
21–50 mm	253 (28)	78 (29)	55 (29)	120 (27)
+51	15 (2)	4 (1)	4 (2)	7 (2)
Tumor positive lymph node
0	500 (55)	151 (55)	101 (53)	248 (55)
1–3	299 (33)	85 (31)	64 (33)	150 (33)
+4	63 (7)	22 (8)	17 (9)	24 (5)
ER-status
Positive	783 (85)	237 (87)	160 (83)	386 (85)
Negative	93 (10)	25 (9)	25 (13)	43 (10)
HER2-status
Positive	119 (13)	44 (16)	23 (12)	52 (12)
Negative	743 (81)	211 (77)	159 (83)	373 (83)
Surgery
Mastectomy	176 (19)	49 (18)	40 (21)	87 (19)
Lumpectomy	710 (77)	216 (79)	148 (77)	346 (77)
Chemotherapy
Yes	413 (45)	100 (36)	88 (46)	225 (50)
No	438 (48)	152 (56)	92 (48)	194 (43)
Endocrine therapy
Yes	731 (80)	220 (81)	149 (78)	362 (80)
No	120 (13)	32 (12)	31 (16)	57 (13)
HER2 therapy
Yes	103 (11)	34 (13)	20 (10)	49 (11)
No	748 (82)	218 (80)	160 (83)	370 (82)

Education categories: short (mandatory school, 7–9 years), medium (senior high school or vocational education, 9–12 years) and long (higher education, ≥13 years); Tumor positive lymph node includes macro- and micrometastasis but not single tumor cells; If the ER status is ≥1% it is registered as positive.

*Missing information on time since diagnosis, n = 8.

Table 2. Associations between education and clinically relevant fear of recurrence among 917 women in follow-up after breast cancer who had follow-up changed from oncologist-led to nurse-led or patient-initiated follow-up, Region Zealand, Denmark, 2016–17.

Time since diagnosis (n)	Educational level (n clinically relevant fear of recurrence/total n)	Crude OR (95% CI)	Adj. OR* (95% CI)
All (n = 917)	Short (95/273)	1 (ref.)	1 (ref.)
	Medium (65/192)	0.96 (0.65;1.42)	0.90 (0.61;1.34)
	Long (134/452)	0.79 (0.57;1.09)	0.71 (0.51;0,99)
≤5 years since diagnosis** (n = 366)	Short	1 (ref.)	1 (ref.)
	Medium	0.82 (0.44;1.51)	0.81 (0.44;1.51)
	Long	0.54 (0.33;0.89)	0.51 (0.30;0.85)
>5 years since diagnosis** (n = 543)	Short	1 (ref.)	1 (ref.)
	Medium	1.16 (0.69;1.93)	1.03 (0.61;1.75)
	Long	1.04 (0.68;1.60)	0.92 (0.59;1.43)

Clinically relevant fear of recurrence defined as >11 on the CARQ-4 scale [19].

*Adjusted for age and cohabitation status.

**Missing information on time since diagnosis, n = 8.

Von Elm E, Altman DG, Egger MP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE): guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–1457.

 PubMed Web of Science ®Google Scholar

Data availability

The data that supports the findings of this study are available from the last author (SD) upon reasonable request.