The relationship between death anxiety and fear of recurrence and progression in chronic illness: A systematic review and meta-analysis

Objective: Recent research has identified fear of recurrence and fear of progression (FORP) as common psychosocial issues among people with chronic illnesses. Similarly, growing studies have identified death anxiety as being a key transdiagnostic construct in mental health, particularly in relation to anxiety. However, the relationship between these constructs has received scarce attention. This systematic review and meta-analysis examined the relationship between FORP and death anxiety across chronic illnesses. Methods: The current review was conducted in line with PRISMA guidelines. We screened 2620 papers for the current systematic review and meta-analysis. In total, 15 studies were included in the final review (N_total = 3506). Results: A meta-analysis revealed a significant and large correlation (r = 0.592) between death anxiety and overall FORP. The type of illness emerged as a significant moderator of this effect, with significantly larger effect sizes found for samples affected by cancer (r = 0.640) compared with other illnesses (r = 0.495). The relationship with death anxiety was equally strong between studies which measured fear of progression versus fear of recurrence. Overall, the studies were generally of high quality with low risk of publication bias. Conclusions: The current findings support the significant relationship between death anxiety and FORP across numerous illness types. The clinical implications include the need to consider death anxiety in the conceptualisation and management of FORP in chronic illness.