Iranian Association for Intelligence and Talent Studies International Journal of Education and Cognitive Sciences 3041-8828 In Press 2027 04 01 Fear of Cancer Recurrence as a Mediator Between Illness Perception and Quality of Life Among Prostate Cancer Survivors Fear of Cancer Recurrence as a Mediator Between Illness Perception and Quality of Life Among Prostate Cancer Survivors 1 18 EN Journal Article 2026 05 15 Purpose: This study examined the mediating role of FCR in the association between illness perception and quality of life among prostate cancer survivors attending a selected hospital affiliated with Shahid Beheshti University of Medical Sciences. Methods and Materials: A cross-sectional analytical study was conducted among 300 prostate cancer survivors. Illness perception was assessed using the Brief Illness Perception Questionnaire, FCR using the Severity subscale of the Fear of Cancer Recurrence Inventory, and quality of life using the EORTC QLQ-C30 Global Health Status/Quality of Life scale. Mediation was tested using PROCESS Model 4 with 10,000 bias-corrected bootstrap resamples while controlling for relevant demographic and clinical variables. Findings: More threatening illness perceptions significantly predicted greater FCR (β = .51, p < .001) and poorer quality of life (β = −.27, p < .001). Greater FCR was independently associated with poorer quality of life (β = −.43, p < .001). The indirect effect of illness perception on quality of life through FCR was significant (B = −0.36, 95% bootstrap CI [−0.49, −0.25]), accounting for approximately 45% of the total association. The adjusted model explained 53% of the variance in quality of life. Conclusion: FCR partially mediated the relationship between illness perception and quality of life. Assessing and targeting threatening illness representations and recurrence-related fears may improve psychosocial adjustment and quality of life among prostate cancer survivors.

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