Randomized Controlled Trial

. 2025 Mar 23;25(1):527.

doi: 10.1186/s12885-025-13639-6.

Assessing the impact of a self-guided digital intervention for fear of cancer recurrence (iConquerFear) in ovarian cancer survivors: a pilot randomised waitlist-controlled trial

Verena S Wu^{1

2}, Allan 'Ben' Smith^{3

4}, Hayley Russell⁵, Adeola Bamgboje-Ayodele⁶, Lisa Beatty^{7

8}, Alison Pearce^{1

9}, Haryana Dhillon⁸, Joanne Shaw⁸, Jan Antony⁵, Joanna Fardell^{10

11

12}, Anupama Pangeni², Cyril Dixon⁵, Orlando Rincones², Laura Langdon⁵, Daniel Costa¹³, Afaf Girgis²

Affiliations

¹ The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia.
² South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia.
³ The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia. ben.a.smith@sydney.edu.au.
⁴ South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia. ben.a.smith@sydney.edu.au.
⁵ Ovarian Cancer Australia, Melbourne, VIC, Australia.
⁶ Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
⁷ College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia.
⁸ Psycho-oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia.
⁹ Sydney School of Public Health, The University of Sydney, Sydney, Australia.
¹⁰ Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia.
¹¹ Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
¹² Crown Princess Mary Cancer Centre, Western Sydney Youth Cancer Service, Westmead Hospital, Westmead, Australia.
¹³ School of Psychology, Faculty of Science, the University of Sydney, Sydney, Australia.

PMID: 40122804
PMCID: PMC11929991
DOI: 10.1186/s12885-025-13639-6

Randomized Controlled Trial

Assessing the impact of a self-guided digital intervention for fear of cancer recurrence (iConquerFear) in ovarian cancer survivors: a pilot randomised waitlist-controlled trial

Verena S Wu et al. BMC Cancer. 2025.

. 2025 Mar 23;25(1):527.

doi: 10.1186/s12885-025-13639-6.

Authors

Affiliations

¹ The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia.
² South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia.
³ The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia. ben.a.smith@sydney.edu.au.
⁴ South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia. ben.a.smith@sydney.edu.au.
⁵ Ovarian Cancer Australia, Melbourne, VIC, Australia.
⁶ Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
⁷ College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia.
⁸ Psycho-oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia.
⁹ Sydney School of Public Health, The University of Sydney, Sydney, Australia.
¹⁰ Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia.
¹¹ Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
¹² Crown Princess Mary Cancer Centre, Western Sydney Youth Cancer Service, Westmead Hospital, Westmead, Australia.
¹³ School of Psychology, Faculty of Science, the University of Sydney, Sydney, Australia.

PMID: 40122804
PMCID: PMC11929991
DOI: 10.1186/s12885-025-13639-6

Abstract

Background: Approximately 50% of ovarian cancer (OC) survivors report fear of cancer recurrence/progression (FCR/P) as the most challenging aspect of living with cancer. This pilot, randomised waitlist-controlled trial aimed to evaluate the feasibility, acceptability, and safety of iConquerFear, a self-guided online FCR intervention for OC survivors.

Methods: Stage I-III OC survivors were recruited via Ovarian Cancer Australia (OCA) between October-December 2022. Participants were randomised to access iConquerFear immediately (intervention) or after 8 weeks (waitlist-control). Primary outcomes were feasibility, acceptability, and safety. Secondary outcomes included: engagement barriers/enablers, perceived impact of iConquerFear, and suggested improvements via semi-structured interviews. Exploratory outcomes included group differences in FCR and FoP after iConquerFear use.

Results: Of 62 eligible survivors, 55 (61%) were randomised (intervention n = 29; control n = 26). At baseline 55% (30/55) reported severe FCR (FCRI-SF ≥ 22). Of those randomised, 51% (n = 28) accessed iConquerFear; 16/28 (57%) users completed ≥ 3/5 modules. Mean post-intervention acceptability score (IEUQ) was 3/4 (SD = 0.8). Three (11%) users withdrew due to distress from iConquerFear. Qualitative interviews (n = 13) identified 6 key themes (e.g., participant factors influencing engagement). Differences between intervention and control group changes in FCR/P were non-significant.

Conclusions: iConquerFear does not appear appropriate for OC survivors in its current format due to limited engagement, varied acceptability, safety concerns and minimal group differences in FCR/P after iConquerFear use. More work is needed regarding how to augment online interventions addressing sensitive issues such as FCR/P in OC survivors (e.g., offering complementary in-person support) to ensure feasibility, acceptability and safety.

Trial registration: This trial is registered with ANZCTR.org (ACTRN12622000592741p) on 21 April 2022.

Keywords: Fear of cancer recurrence; Fear of progression; Online; Ovarian cancer; Self management; Web-based; eHealth.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the University of New South Wales Ethics Committee (approval number: HC220186). Informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: Allan ‘Ben’ Smith, Adeola Bamgboje-Ayodele, Lisa Beatty, Alison Pearce, Joanna Fardell, and Afaf Girgis hold a copyright licensed to Blue Note Therapeutics, Inc., for the ConquerFear and iConquerFear interventions. All other authors have no competing interests to declare. Additional files: Additional file 1: Semi-structured interview schedule (Additional File 1.docx). Additional file 2: Measures for exploratory outcomes (Additional File 2.docx).

Figures

**Fig. 1**
CONSORT participant recruitment flow diagram

**Fig. 2**
User ratings of acceptability (IEUQ). Note: Responses depicted in blue (i.e., Very and Mostly) are indicative of higher levels of acceptability for most domains, excluding privacy concerns

See this image and copyright information in PMC

References

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Assessing the impact of a self-guided digital intervention for fear of cancer recurrence (iConquerFear) in ovarian cancer survivors: a pilot randomised waitlist-controlled trial

Affiliations

Assessing the impact of a self-guided digital intervention for fear of cancer recurrence (iConquerFear) in ovarian cancer survivors: a pilot randomised waitlist-controlled trial

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous