Validity of the German Version of the FCR-1r Questionnaire in Patients with Urologic Cancer.

INTRODUCTION

Fear of cancer recurrence (FCR) is a prevalent and distressing issue for a significant proportion of cancer patients across various disciplines, yet it remains one of the most frequently unaddressed psychosocial needs. A key barrier to identifying affected individuals is the lack of brief screening tools suitable for clinical settings. The objective of this research is to validate the one-item FCR screening tool (revised Fear of Cancer Recurrence-1 [FCR-1r]) in a German cohort of urologic cancer patients. Validating such an ultra-brief measure may help address this clinically relevant gap and serve as a viable, clinically applicable alternative to lengthy questionnaires.

METHODS

Statistical analyses were conducted using R software. Criterion validity was assessed against the Concerns About Recurrence Questionnaire-4 (CARQ-4). Convergent validity was tested against the Fear of Progression Questionnaire - Short Form (FoP-Q-SF) and Generalised Anxiety Disorder-7 (GAD-7). Discriminant validity was tested against the Health Literacy Survey-European-Questionnaire 16 (HLS-EU-Q16). Validity was assessed using chi-square tests with phi coefficients, accuracy measures, negative and positive predictive values, sensitivity, specificity and odds ratios.

RESULTS

The final analysis sample consisted of 236 participants with complete data on all study measures. The FCR-1r demonstrated excellent criterion validity with respect to the CARQ-4 (χ2[1] = 101.97, p < 0.001, φ = 0.66), with an overall accuracy of 84% (95% CI: 79-89%). Sensitivity was 84%, and specificity was 85%. The analysis of convergent validity revealed a moderate association with both the FoP-Q-SF (χ2[1] = 20.25, p < 0.001, φ = 0.29; accuracy 62% [95% CI: 56-68%]) and the GAD-7 (χ2[1] = 11.82, p < 0.001, φ = 0.22; accuracy 64% [95% CI: 58-70%]). The analysis of discriminant validity showed no significant association between the FCR-1r and health literacy (HLS-EU-Q16): χ2(1) = 3.44, p = 0.064, φ = 0.12.

CONCLUSION

The German version of the FCR-1r demonstrates good psychometric properties, confirming its validity as a tool for assessing FCR in clinical practice.