The Centers for Disease Control and Prevention estimates nearly 40 percent of Americans will be diagnosed with cancer at some point in their life. Currently, there are more than 20 million cancer survivors in the United States, and that number is growing.

While surviving cancer is the best-case scenario, it comes with its own issues: potential dental problems, infertility, heart and lung problems, osteoporosis, and more. Doctors have also documented another long-term psychological consequence: fear of the cancer coming back.

A systematic review published earlier this year found that the most common unmet need among cancer survivors is calming that fear. The constant worry often leads to depression, impaired daily functioning, and reduced quality of life. Many cancer survivors worry for years and report that they feel as worried as when they were first diagnosed with cancer.

The review combined data from 46 studies with more than 9,000 participants from 13 countries. The studies all used data from the Fear of Cancer Recurrence Inventory, a widely-accepted survey to identify clinically-significant fear. Nearly 60 percent of study participants had fears that were clinically significant, and nearly 20 percent scored at the highest level, meaning their fear of cancer recurrence was debilitating.

These fears were prevalent regardless of the participant’s type of cancer and where they lived. Women were more likely to experience clinically-significant fear compared to men, and young people were more likely to experience clinically-significant fear compared to older people.

What’s the Solution?

The first step is to recognize when fears become a significant problem. If you are a cancer survivor, you should report worries that interfere with relationships and daily activities to your health care provider. If you are afraid to go to your follow-up cancer appointment or if you feel hopeless about the future, those are also signs you may need some extra help. In addition, be on the lookout for difficulty sleeping or eating well and trouble concentrating or making decisions.

Researchers have tested a wide range of interventions to address the fear of cancer recurrence. One systematic review found therapy is an effective treatment for this problem and that improvements, although small, lasted on average more than seven months after therapy ended. Another found that mind-body interventions, such as meditation, relaxation skills, and cognitive-behavioral training are effective at addressing fear of cancer recurrence.

There is evidence that participating in a support group of cancer survivors often creates a sense of belonging that helps survivors feel less alone and more understood.

It’s also important to adhere to your follow-up care plan, even though those appointments might temporarily raise your anxiety levels.

The take-home message: Fear of recurrence is a significant problem for cancer survivors, but one that health care providers can address with follow-up care and therapy.