Associations between fear of cancer recurrence and post-traumatic growth in patients with primary liver cancer: a latent profile analysis and mediation analysis.

Background: Promoting post-traumatic growth in patients with liver cancer is of great significance for improving their quality of life and psychosocial adaptation. Previous studies have demonstrated that fear of cancer recurrence (FCR) is a risk factor that hinders post-traumatic growth (PTG). However, existing research often overlooks the heterogeneity of fear of cancer recurrence, and the pathway differences between distinct latent classes and post-traumatic growth remain unclear. Therefore, this study aims to identify the latent classes of fear of cancer recurrence in patients with primary liver cancer and to examine the mediating roles of perceived social support and self-efficacy between different classes and post-traumatic growth. Methods: The cross-sectional survey was organized between February and December 2025. Patients with primary liver cancer from a tertiary hospital in Guangzhou city were recruited through convenience sampling method. The levels of FCR, perceived social support, self-efficacy, and PTG were measured using paper-based questionnaires, and the relationships among variables were analyzed using Pearson correlation analysis, latent profile analysis, and multicategorical independent variable mediation analysis. Results: Three latent profiles of FCR were identified: low fear-psychologically well-adapted group (29.32%), high fear-social functioning concerns group (35.50%), and moderate-to-high fear-treatment concerns group (35.18%). Analysis of influencing factors showed that type of medical insurance, presence of comorbidities, and occupational status were predictors of different latent classes of fear of cancer recurrence in patients with primary liver cancer (P < 0.05). The differences were found in the total scores and subscales of perceived social support, self-efficacy, and PTG among patients with different latent FCR profiles. Mediation analysis showed that, with the low fear-psychologically well-adapted group as the reference, the relative mediation effects were significant for both the high fear-social functioning concerns group and the moderate-to-high fear-treatment concerns group. Conclusion: Fear of cancer recurrence demonstrates marked heterogeneity across individuals diagnosed with primary liver cancer. Clinicians should implement targeted interventions for patients with different FCR profiles to mitigate its negative impact and promote psychological growth by activating their social support systems and enhancing self-efficacy.