Background Whereas religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, we conducted a meta-analysis of the relationship between R/S and patient-reported physical health in cancer patients. Methods A search of PubMed, PsycInfo, CINAHL, and Cochrane Library yielded 2,073 abstracts, which were independently evaluated by pairs of raters. Meta-analysis was conducted on 497 effect sizes from 101 unique samples encompassing over 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and ‘other’ dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher's z) were calculated using generalized estimating equations with robust variance estimation. Results Overall R/S was associated with overall physical health (z=.153, p<.001); this relationship was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z=.167, p<.001), functional well-being (z=.343, p<.001), and physical symptoms (z=.282, p<.001). Cognitive R/S was associated with physical well-being (z=.079, p<.05) and functional well-being (z=.090, p<.01). ‘Other’ R/S was associated with functional well-being (z=.100, p<.05). Conclusions Results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients’ religious and spiritual needs as part of comprehensive cancer care.

Purpose Religion and spirituality (R/S) are patient-centered factors and often resources for managing the emotional sequelae of the cancer experience. Studies investigating the relationship between R/S (e.g., beliefs, experiences, coping) and mental health (e.g., depression, anxiety, well-being) in cancer have used very heterogeneous measures, with correspondingly inconsistent results. A meaningful synthesis of these findings has been lacking; thus, the purpose of this study was to conduct a meta-analysis of the research on R/S and mental health. Methods Four electronic databases were systematically reviewed and 2,073 abstracts met initial selection criteria. Reviewer pairs applied standardized coding schemes to extract correlational indices of the relationship between R/S and mental health. A total of 617 effect sizes from 148 eligible studies were synthesized using meta-analytic generalized estimating equations; subgroup analyses were performed to examine moderators of effects. Results The estimated mean correlation (Fisher z) was 0.19 (95% CI 0.16–0.23), which varied as a function of R/S dimension: affective, z=0.38 (95% CI 0.33-0.43); behavioral, z=0.03 (95% CI -0.02-0.08); cognitive, z=0.10 (95% CI 0.06-0.14); and ‘other,’ z=0.08 (95% CI 0.03-0.13). Aggregate, study-level demographic and clinical factors were not predictive of the relationship between R/S and mental health. There was little indication of publication or reporting biases. Conclusions The relationship between R/S and mental health is generally a positive one. The strength of that relationship is modest and varies as a function of R/S dimensions and mental health domains assessed. Identification of optimal R/S measures and more sophisticated methodological approaches are needed to advance research.

PURPOSE Young adults (YAs; ages 18–39) with cancer face interrupted developmental milestones and increased stressors that can adversely influence psychosocial adjustment. Transitioning from active treatment to post-treatment survivorship can be particularly challenging. The purpose of this study is to describe the health-related quality of life (HRQL) and psychological adaptation of YAs post-treatment relative to young adults without cancer. METHODS Three cohorts of YAs of mixed cancer diagnoses (N=120, 0–12 months post-treatment; N=102, 13–24 months post-treatment; and N=113, 25–60 months post-treatment; combined M=31.8 years old, combined gender=68% women) and an age, education, gender, and partner-status matched group of healthy control participants (HCs; N=335) were recruited via an online research panel. All participants completed measures assessing demographic and clinical characteristics, HRQL (physical, emotional, social, and spiritual), and psychological adaptation (anxiety, depression, positive affect, posttraumatic growth). Measure content was slightly modified for applicability to HCs without a cancer history. RESULTS Multivariate analysis of covariance found a significant main effect for group (YAs versus HCs) and a significant group-by-cohort interaction. YAs reported poorer physical (p=.005, d=.22) and emotional well-being (p=.011, d=.20) but better social well-being (p<.001, d=.49). YAs reported comparatively stable scores (p=.74) for posttraumatic growth compared to HCs, who reported greater posttraumatic growth across cohorts (p=.01, d=16). CONCLUSIONS Findings underscore the negative and positive sequelae for YAs and highlight the need for comprehensive assessment among YA survivors of cancer. A matched, HC group allows the HRQL and psychological adaptation of YAs to be placed in context, enabling a more precise determination of the impact of cancer on YAs.

Background Religion and spirituality (R/S) play an important role in the daily lives of many cancer patients. There has been great interest in determining whether R/S factors are related to clinically-relevant health outcomes. This meta-analytic review examined associations between dimensions of R/S and social health (e.g., social roles and relationships). Methods A systematic search of PubMed, PsycInfo, Cochrane Library, and CINAHL databases was conducted, and data were extracted by four pairs of investigators. Bivariate associations between specific R/S dimensions and social health outcomes were examined in a meta-analysis using a generalized estimating equation (GEE) approach. Results A total of 78 independent samples encompassing 14,277 patients were included in the meta-analysis. Social health was significantly associated with overall R/S (Fisher z effect size = .20, P< .001), and with each of the R/S dimensions (affective R/S effect size = .32, P< .001; cognitive R/S effect size = .11, P< .01; behavioral R/S effect size = .08, P < .05; and ‘other’ R/S effect size = .13, P < .001). Within these dimensions, specific variables tied to social health included spiritual well-being, spiritual struggle, images of God, R/S beliefs, and composite R/S measures (all P’s < .05). None of the demographic or clinical moderating variables examined was significant. Conclusions Several R/S dimensions are modestly associated with patients’ capacity to maintain satisfying social roles and relationships in the context of cancer. Further research is needed to examine the temporal nature of these associations and the mechanisms that underlie them.

Purpose Minimal clinical trial participation among adolescents and young adults (AYAs) with cancer limits scientific progress and ultimately their clinical care and outcomes. These analyses examine the current state of AYA clinical research participation at a Midwestern comprehensive cancer center and affiliated pediatric hospital to advise program development and increase availability of trials and AYA participation. Enrollment is examined across all diagnoses, the entire AYA age spectrum (15–39), and both cancer therapeutic and supportive care protocols. Methods This study was a retrospective review of electronic medical records via existing databases and registries for all AYAs. Data were collected for AYAs seen by an oncologist at the adult outpatient cancer center or at the pediatric hospital between the years 2010 and 2014. Descriptive statistics and logistic regression analyses were conducted to characterize this sample. Results In the pediatric setting, 42.3% of AYAs were enrolled in a study compared to 11.2% in the adult setting. Regression analyses in the pediatric setting revealed that AYAs with private insurance or Caucasian race were more likely to participate. Within the adult setting, ethnicity, race, insurance, and diagnosis were associated with study participation; 54.8% of study enrollments were for cancer therapeutic and 43.4% for supportive care studies. Conclusions These results are comparable to previously published data and support the need for new local and national AYA initiatives to increase the availability of and enrollment in therapeutic clinical trials. The same is true for supportive care studies which play a crucial role in improving quality of life.