ArticleEndocrine2026
Validation of the Czech version of the nine-item Fear of Cancer Recurrence Inventory in differentiated thyroid cancer survivors.
Article in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeFear of cancer recurrence (FCR) is a common psychological concern among cancer survivors and is associated with anxiety, depression, and impaired quality of life. Brief validated instruments are needed for routine clinical use; however, no Czech version has been available to date. The nine-item Fear of Cancer Recurrence Inventory – Short Form (FCRI-SF-9) corresponds to the Severity subscale of the original instrument and was conceptually designed to assess a central, theoretically unidimensional component of FCR. This study aimed to validate the Czech version (FCRI-SF-9-CZ) in survivors of differentiated thyroid carcinoma (DTC).
methodsThis cross-sectional validation study (June 2022–July 2023) included patients with histologically confirmed DTC recruited at the Department of Nuclear Medicine, České Budějovice Hospital. Participants completed the FCRI-SF-9-CZ, the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the EQ-5D-5 L. Psychometric evaluation comprised internal consistency, test–retest reliability, and confirmatory factor analysis (CFA). In line with methodological recommendations for ordinal Likert-type data, CFA was primarily conducted using diagonally weighted least squares (DWLS) but for comparison CFA utilizing maximum likelihood estimator with robust standard errors (MLR) and DWLS while treating data as continuous was also conducted. Criterion validity was assessed through correlations with psychological measures and thyroid-related laboratory parameters (TSH, fT4, fT3, thyroglobulin, and anti-thyroglobulin antibodies).
resultsOf 341 collected questionnaires, 312 were eligible for analysis (mean age 54.9 ± 15.3 years; 84% female). The FCRI-SF-9-CZ demonstrated good internal consistency (Cronbach’s α = 0.78) and excellent test–retest reliability (ICC(3,1) = 0.995; 95% CI: 0.990–0.998). Confirmatory factor analysis supported the theoretically expected one-factor structure of the Severity subscale. Although fit indices varied across estimation approaches, the latent structure and factor loadings were stable and conceptually coherent. FCRI-SF-9-CZ scores showed moderate correlations with anxiety (ρ = 0.35, p < 0.001) and depression (ρ =0.25, p < 0.001), but no association with overall quality of life (ρ = − 0.02, p = 0.73) or thyroid-related laboratory measures.
conclusionsThe FCRI-SF-9-CZ is a valid and reliable instrument for assessing fear of cancer recurrence in DTC survivors. Its brevity, theoretical coherence, and satisfactory psychometric performance support its use as a screening tool in routine oncological follow-up and survivorship care.
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