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.

宫颈癌是全球女性常见的恶性肿瘤之一，中青年患者发病率逐年上升，该群体面临疾病进展恐惧和癌症信息过载的双重压力，易降低治疗决策参与度。现有研究多聚焦单一因素作用，对信息超载通过恐惧情绪抑制决策参与的中介作用机制缺乏系统阐释。

探讨恐惧疾病进展在中青年宫颈癌患者癌症信息超载与参与治疗决策间的中介效应。

采用便利抽样法，选取2024年5—11月无锡市妇幼保健院肿瘤科收治的240例中青年宫颈癌患者为研究对象，采用一般资料调查问卷、癌症信息超载量表、汉化版恐惧疾病进展简化量表和癌症患者参与治疗决策调查问卷进行调查。采用Process插件中的Model 4进行中介效应分析。

共发放240份问卷，回收有效问卷221份，有效回收率为92.1%。221例中青年宫颈癌患者癌症信息超载量表总分为（22.96±3.04）分、恐惧疾病进展简化量表总分为（42.05±6.08）分及癌症患者参与治疗决策调查问卷总分为（33.81±7.50）分。相关性分析结果显示，癌症信息超载总分与恐惧疾病进展总分呈正相关（r=0.562，P<0.01），与参与治疗决策总分呈负相关（r=-0.460，P<0.01）；恐惧疾病进展总分与参与治疗决策总分呈负相关（r=-0.473，P<0.01）。多元线性回归分析结果显示，家庭人均月收入（β=-1.546，P=0.004）、癌症信息超载（β=-0.676，P<0.001）、恐惧疾病进展（β=-0.396，P<0.001）是癌症患者参与治疗决策的影响因素。中介效应分析结果显示，癌症信息超载对参与治疗决策具有负向预测作用（β=-0.27，P<0.001），癌症信息超载对恐惧疾病进展具有正向预测作用（β=0.56，P<0.001），恐惧疾病进展对参与治疗决策具有负向预测作用（β=-0.32，P<0.001）；恐惧疾病进展在中青年宫颈癌患者癌症信息超载与参与治疗决策间的中介效应值为-0.18（P<0.001），占总效应的39%（-0.18/-0.46），起部分中介效应。

癌症信息超载和恐惧疾病进展均可直接影响中青年宫颈癌患者参与治疗决策，且癌症信息超载也可通过恐惧疾病进展间接影响患者参与治疗决策。医务人员需从环境、认知和行为层面采取相应的措施帮助患者筛选、处理无效信息，降低其对疾病的恐惧感，从而提高癌症患者参与治疗决策的积极性。