Cervical cancer is a common malignant tumor among women worldwide, with the incidence rate among young and middle-aged patients increasing annually. This demographic faces dual pressures of fear of disease progression and cancer-related information overload, which can easily diminish their engagement in treatment decision-making. Existing research predominantly focused on individual factors, while lacking systematic exploration of the mediating mechanism through which information overload suppressed decision-making participation via fear-related emotional responses.

To explore the mediating effect of fear of disease progression between cancer information overload and participation in treatment decision-making in young and middle-aged cervical cancer patients.

Using convenience sampling, 240 middle-aged and young cervical cancer patients admitted to the Department of Oncology, Wuxi Maternal and Child Health Hospital from May to November 2024 were selected as research subjects. A cross-sectional survey was conducted using general information questionnaires, the Cancer Information Overload Scale, the Fear of Progression Questionnaire-short Form, and the Cancer Patient Participation in Treatment Decision-making Questionnaire. Mediation effect analysis was performed using Model 4 in the Process plugin.

A total of 240 questionnaires were distributed, and 221 valid questionnaires were collected, with a valid recovery rate of 92.1%. 221 young and middle-aged cervical cancer patients had a total score of (22.96±3.04) on the Cancer Information Overload Scale, (42.05±6.08) on the Simplified Scale of Fear of Disease Progression, and (33.81±7.50) on the Questionnaire of Participation in Decision-making by Patients with Cancer in the Treatment of Cervical Cancer. Total scores of cancer information overload was positively correlated with fear of disease progression scores (r=0.562, P<0.01) and negatively correlated with cancer patients participation in treatment decision-making scores (r=-0.460, P<0.01), and fear of disease progression scores was negatively correlated with cancer patients' participation in treatment decision-making scores (r=-0.473, P<0.01). Multiple linear regression analysis indicated that monthly per capita household income (β=-1.546, P=0.004), cancer information overload (β=-0.676, P<0.001), and fear of disease progression (β=-0.396, P<0.001) were influencing factors for treatment decision-making participation among cancer patients. Mediation effect analysis revealed that cancer information overload exerted a negative predictive effect on treatment decision-making participation (β=-0.27, P<0.001); cancer information overload positively predicted fear of disease progression (β=0.56, P<0.001), while fear of disease progression had a negative predictive effect on treatment decision-making participation (β=-0.32, P<0.001). The results of the mediation effect analysis showed that fear of disease progression had a mediation effect value of -0.18 (P<0.001) between cancer information overload and participation in treatment decision-making in young and middle-aged cervical cancer patients, which accounted for 39% of the total effect (-0.18/-0.46), and served as a partial mediation effect.

Both cancer information overload and fear of disease progression can directly affect the participation decision of young and middle-aged cervical cancer patients in treatment, and cancer information overload can also indirectly affect the participation decision of patients in treatment through fear of disease progression. Medical personnel should actively take relevant measures to help patients screen and process invalid information and reduce their fear of disease, so as to improve the motivation of cancer patients to participate in treatment decision-making.