Acceptance and commitment therapy effectiveness for fear of cancer recurrence: A systematic review and meta-analysis

Purpose: This systematic review and meta-analysis aimed to assess the impact of Acceptance and Commitment Therapy (ACT) on Fear of cancer recurrence (FCR) among cancer survivors. Methods: The various databases including PubMed, EMBASE, CINAHL, Scopus, The Cochrane Library, Wanfang data, CNKI, CBM, and CQVIP were searched from their start dates up to June 1, 2024. Meta-analysis was conducted using RevMan 5.3 and Stata 17.0. Sub-analysis was performed to identify sources of heterogeneity and to mitigate the impact of confounding variables. Results: The meta-analysis included 11 studies, encompassing 1093 participants. Findings from a random-effects analysis, indicated that ACT significantly reduced FCR in cancer survivors [SMD =-1.26, 95 % CI (-1.70,-0.81), P < 0.051, both at three months follow-up [SMD =-1.76, 95 % CI (-2.75,-0.76), P < 0.051 and six months follow-up [SMD =-0.84, 95 % CI (-1.34,-0.34), P < 0.051. The results of subgroup analyses revealed that the duration, format, and location of interventions could affect outcomes. At the same time,the results revealed that ACT can reduce anxiety and experiential avoidance in cancer survivors, though its effect on fatigue requires further investigation. The quality assessment results of the included literature ranged from low to high risk of bias. Conclusions: ACT can effectively reduce FCR, experiential avoidance, and anxiety in cancer survivors, though it did not significantly affect fatigue levels. Further high-quality RCTs are needed to elucidate the effects of ACT on FCR in cancer survivors.