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Psychooncology. 2018 Nov;27(11):2602-2608. doi: 10.1002/pon.4839. Epub 2018 Aug 9.

Examining the dimensionality of the Fear of Cancer Recurrence Inventory.

Author information

School of Nursing, Queen's University, Kingston, Ontario, Canada.
L.S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
After Cancer Treatment Transition Clinic, Women's College Hospital, Toronto, Ontario, Canada.
Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.



Fear of cancer recurrence (FCR) is a common concern among cancer survivors, and the Fear of Cancer Recurrence Inventory (FCRI) is a frequently used measure to assess FCR. Given that the dimensionality of FCR has received recent debate, the overall goal of this secondary analysis was to re-examine the dimensionality of the FCRI using confirmatory factor analyses (CFA) to compare models of FCR, using data from a large sample of cancer survivors.


Three models of FCR (including unidimensional and multidimensional models of the FCRI) were informed by the literature and proposed a priori. Separate CFAs were conducted to test the fit of each model to the data, and models with acceptable fits were compared.


Of all the tested FCR models, a multidimensional first-order model aligned with the originally developed 7-subscale FCRI revealed the best fit to the data (χ2  = 3359.135, P < .0001, df = 795, RMSEA = 0.057 [0.055, 0.059], CFI = 0.897, TLI = 0.888). When this 7-factor structure was loaded onto a single, second-order factor of overall FCR, the model fit statistics were slightly poorer (χ2  = 3459.632, P < .0001, df = 807, RMSEA = 0.058 [0.056, 0.060], CFI = 0.893, TLI = 0.886). However, the difference between the models was significant (chi-square difference = 103.142, P < .0001, df = 12) indicating that the first-order model was a better fit to the data.


These results align with empirical and theoretical literature that supports the use of the FCRI as a multidimensional scale. Implications of results are discussed in light of FCR conceptualization and measurement.


cancer; cancer survivors; factor analysis; fear; oncology; patient-reported outcome measures; psycho-oncology; recurrence; survivorship


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