Fear of cancer occurrence in breast cancer previvors: a scoping review of the literature.

OBJECTIVE: Pathogenic variants (PVs) in genes create a unique population of "previvors," individuals who have no personal history of a cancer diagnosis, but carry chronically elevated lifetime cancer risk. PVs in breast cancer previvors negatively impact body image and family planning, and increase uncertainty and anxiety. How fear of cancer occurrence (FOCO) is experienced in previvors is not well described in the literature. This scoping review aimed to describe how FOCO manifests among breast cancer previvors. METHODS: Guided by Joanna Briggs Institute (JBI) scoping review methodology, a search was conducted across CINAHL, PsycINFO, PubMed, and Scopus databases. Records were screened and data extracted using Covidence. Inclusion criteria were female sex, presence of a breast cancer PV, no personal history of breast cancer, and description(s) of cancer-related fear. RESULTS: 1,022 records were screened, 10 articles (n = 620 previvors) met inclusion criteria. FOCO manifested among breast cancer previvors in three ways, (1) perception of cancer occurrence, particularly if a cancer diagnosis was perceived by the previvor as inevitable; (2) misinterpretation of information from clinician communications, websites, or somatic sensations; and (3) heightened "scanxiety" of a cancer diagnosis during routine breast screening. CONCLUSION: FOCO may represent a distinct and clinically important experience to individuals living with an increased predisposition to developing breast cancer. Previvors must navigate both present and future cancer fears, distinguishing them from both average-risk individuals and cancer survivors. However, more research is needed to better characterize and measure FOCO among individuals with an increased risk of developing breast cancer.