Purpose <p>This study aimed to investigate the relationship between fear of progression and post-traumatic growth in adults with lymphoma and determine whether avoidance coping mediates this relationship.</p> Methods <p>This was a multicenter, cross-sectional study. We used convenience sampling to recruit 322 patients with lymphoma from four tertiary hospitals in Fujian and Anhui provinces, China, between February and August 2023. Participants completed demographic and clinical information questionnaires, the Fear of Progression Questionnaire-Short Form, the Medical Coping Modes Questionnaire, and the Post-traumatic Growth Inventory.</p> Results <p>Among Chinese patients with lymphoma, the total fear of progression, avoidance coping, and post-traumatic growth scores were 31.91 ± 8.29, 15.67 ± 3.07, and 59.45 ± 14.61, respectively. Fear of progression was positively correlated with avoidance coping, with no significant associations between fear of progression and post-traumatic growth. Avoidance coping was positively correlated with post-traumatic growth. Additionally, avoidance coping exerted a suppression effect between fear of progression and post-traumatic growth.</p> Conclusion <p>Patients with lymphoma reported moderate-to-high fear of progression and high post-traumatic growth, alongside moderate avoidance coping. Fear of progression predicted post-traumatic growth, while avoidance coping suppressed this effect. These findings highlight the complex role of avoidance coping in psychological adaptation and underscore the need for further qualitative and research to explore its mechanisms in post-traumatic growth. The results offer valuable insights for developing culturally sensitive psychosocial interventions and coping assessments tailored to adults with lymphoma.</p> Trial registration <p>Not applicable.</p>