• Harin Kim, Wonjun Ji, Jong Won Lee, Min-Woo Jo, Sung-Chol Yun, Sei Won Lee, Chang-Min Choi, Geun Dong Lee, Hui Jeong Lee, Eulah Cho, Yura Lee, and Seockhoon Chung.
• Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2023 Aug 7; 38 (31): e236e236.

BackgroundLung cancer is associated with significant psychological distress, including fear of progression (FoP). Because insomnia and depression are highly prevalent and associated with FoP, we examined the association between FoP, insomnia, and depression in cancer patients. Furthermore, we tested the mediation effect of cancer-related dysfunctional beliefs about sleep (C-DBS) on this association.MethodsWe analyzed data collected from patients with surgically resected non-small cell lung cancer from a single-center randomized controlled study investigating digital healthcare applications. Baseline demographic and clinical variables were collected. In addition, self-reported questionnaires including the Fear of Progression Questionnaire-Short Form, Patients Health Questionnaire-9 items (PHQ-9), Insomnia Severity Index, and C-DBS were administered.ResultsAmong the 320 enrolled patients with lung cancer, a regression model showed that FoP was predicted by age (β = -0.13, P = 0.007), PHQ-9 (β = 0.35, P < 0.001), and C-DBS (β = 0.28, P < 0.001). Insomnia did not directly influence FoP, but C-DBS mediated the association. Depression directly influenced FoP, but C-DBS did not mediate this association.ConclusionAmong patients with surgically resected lung cancer, C-DBS mediated the effects of severity of insomnia on FoP. Depression directly influenced FoP, but C-DBS did not influence this association. To reduce FoP among patients with lung cancer, C-DBS should be addressed in the cognitive behavioral therapy module.© 2023 The Korean Academy of Medical Sciences.

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