Smartphone-based psychotherapy interventions may reduce fear of cancer recurrence (FCR) among breast cancer (BC) survivors. These findings were published in the Journal of Clinical Oncology.

Survival rates for breast cancer have been increasing and the 10-year survival rate is now greater than 90%. However, many survivors report ongoing FCR. Previous studies have found that some interventions improve FCR-related stress, but these interventions have low patient participation and there likely aren’t enough therapists for wide-spread intervention scaling.

To evaluate a more scalable approach, 447 breast cancer survivors living in Japan were randomly assigned 1:1 to problem-solving therapy (PST) and behavioral activation (BA; 223 patients) or a waitlist (224 patients) for 8 weeks. The PST intervention was the iPhone/iPad-based application Kaiketsu-App, which comprised nine 10-minute sessions, and the BA intervention was the smartphone application Genki-App, which comprised six 10-minute sessions. The waitlist group had access to the apps at week 8 of the study. The primary outcome was the difference in the Japanese version of the Concerns About Recurrence Scale (CARS-J) scores between the 2 cohorts at week 8.

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Participants in the intervention and control cohorts were median age 45 years; 46.2% and 40.2% had undergone breast cancer surgery at least 1 to 2 years previously and 65.9% and 64.3% had greater FCR, respectively.

At week 8, the intervention cohort had significantly greater reductions in CARS-J (adjusted mean difference [aMD], −1.39; P <.0001) and Fear of Cancer Recurrence Inventory-short form (FCRI-SF; aMD, −1.65; P <.0001) scores than did the controls.

Among the intervention recipients, no significant change in CARS-J (P =.59) or FCRI-SF (P =.16) scores were observed between weeks 8 and 24, indicating a lasting effect on FCR.

This study was limited by only recruiting survivors with access to an iPhone or iPad.

These data indicated that mobile-based interventions may be a more scalable and effective approach for reducing FCR among breast cancer survivors.

Disclosure: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Akechi T, Yamaguchi T, Uchida M, et al. Smartphone psychotherapy reduces fear of cancer recurrence among breast cancer survivors: a fully decentralized randomized controlled clinical trial (J-SUPPORT 1703 Study). J Clin Oncol. Published online November 2, 2022. doi:10.1200/JCO.22.00699