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Cancer. 2015 Nov 1;121(21):3760-8. doi: 10.1002/cncr.29353. Epub 2015 Aug 10.

Religion, spirituality, and physical health in cancer patients: A meta-analysis.

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Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida.
Department of Educational Psychology, University of Texas at Austin, Austin, Texas.
Department of Psychology, University of Connecticut, Storrs, Connecticut.
Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina.
Behavioral Medicine Division, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois.
Department of Psychology, University of Notre Dame, Notre Dame, Indiana.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois.


Although 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, a meta-analysis of the relation between R/S and patient-reported physical health in cancer patients was performed. A search of PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library yielded 2073 abstracts, which were independently evaluated by pairs of raters. The meta-analysis was conducted for 497 effect sizes from 101 unique samples encompassing more than 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 z scores) were calculated with generalized estimating equations with robust variance estimation. Overall R/S was associated with overall physical health (z = 0.153, P < .001); this relation was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z = 0.167, P < .001), functional well-being (z = 0.343, P < .001), and physical symptoms (z = 0.282, P < .001). Cognitive R/S was associated with physical well-being (z = 0.079, P < .05) and functional well-being (z = 0.090, P < .01). 'Other' R/S was associated with functional well-being (z = 0.100, P < .05). In conclusion, the 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.


cancer; meta-analysis; quality of life; religion; spirituality

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