{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:04:18Z","timestamp":1784199858090,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many testicular cancer patients of reproductive age experience reproductive concerns. Metacognitions may alleviate patients' fear of progression and reproductive concerns. However, this relationship has not been well established in testicular cancer patients of reproductive age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examines the level of reproductive concerns and explores how fear of progression mediates the relationship between metacognitions and reproductive concerns in testicular cancer patients of reproductive age in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study employed a quantitative cross\u2010sectional design and was reported in accordance with the STROBE guidelines for observational research. A convenience sample of 192 testicular cancer patients of reproductive age was recruited from a tertiary specialized oncology hospital in Guangzhou, Guangdong, China. Data were collected through the WeChat mini program \u201cQuestionnaire Star\u201d using \u201cthe general data questionnaire\u201d, the Metacognitions Questionnaire\u201030 (MCQ\u201030), the Fear of Progression Questionnaire\u2013Short Form (FoP\u2010Q\u2010SF), and the Reproductive Concerns After Cancer\u2013Male scale (RCAC\u2010M) instruments. The data were analyzed using descriptive statistics, Pearson correlation analyses, and simple mediation effect analysis via the PROCESS macro program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Reproductive concerns were at a moderate level (57.86\u2009\u00b1\u200910.93), and positively associated with metacognitions (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.358,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and fear of progression (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.523,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Mediation analysis revealed that metacognitions had a total effect path coefficient of 0.317 on reproductive concerns (bootstrap 95% CI: 0.202\u20130.432). The direct effect path coefficient was 0.152 (bootstrap 95% CI: 0.026\u20130.277), while the mediating effect through fear of progression was 0.166 (bootstrap 95% CI: 0.094\u20130.239), representing 52.4% of the total effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In testicular cancer patients of reproductive age, metacognitions are significantly associated with reproductive concerns, and fear of progression acts as a mediating factor. Interventions aimed at improving metacognition levels and reducing fear of progression may help alleviate reproductive concerns in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72042","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T03:20:25Z","timestamp":1781580025000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metacognitions and Reproductive Concerns in Testicular Cancer Patients of Reproductive Age: The Mediating Role of Fear of Progression"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4095-1536","authenticated-orcid":false,"given":"Ya","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou 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Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0157-1171","authenticated-orcid":false,"given":"Xia","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6188-5890","authenticated-orcid":false,"given":"HuiMing","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou 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