OBJECTIVE: To identify latent profiles of Fear of Progression (FoP) in parents of children with cancer, explore their associated factors, and test the mediating role of Sense of Coherence (SOC) between FoP and psychological distress (PD). METHODS: A cross-sectional study was conducted with 273 parents of children with cancer in China. We used latent profile analysis (LPA) to identify FoP profiles, multinomial logistic regression to determine associated factors, and mediation analysis to test the role of SOC. RESULTS: Three distinct FoP profiles were identified: medication sensitive with low fear (38%), treatment sensitive with moderate fear (21%), and overall high fear (41%). These profiles were significantly differentiated by disease-related (e.g., treatment history), individual-related, and interpersonal-related (e.g., self-disclosure) factors. Across the sample, higher FoP was associated with greater PD. Importantly, mediation analyses revealed that SOC significantly mediated the relationship between FoP and PD for the moderate and high FoP profiles, but not for the low LoP profile. CONCLUSIONS: Parents of children with cancer exhibit heterogeneous FoP profiles. SOC acts as a crucial mediator between FoP and PD, particularly for parents with moderate and high FoP profiles. These findings underscore the importance of screening for specific FoP profiles and suggest that tailored interventions designed to enhance SOC could effectively reduce PD in high-risk parents.