Religion/Spirituality and Health in the Context of Cancer: Cross-Domain Integration, Unresolved Issues, and Future Directions

Religion/spirituality (R/S) was historically considered outside the purview of modern medical science. Nevertheless, the past 3 decades have seen a surge of interest in the sociocultural contributors to disease as well as an awareness of the importance of R/S to patients. Consequently, a large and heterogeneous literature examining relations between R/S and patient-reported health among individuals with cancer has emerged. Although components of this literature have been described in some review articles,1-3 there have been few attempts to quantitatively synthesize findings to examine whether R/S is related to cancer patients’ or survivors’ health and, if so, how. Previous articles in this issue of Cancer describe the results of our efforts to address these questions with a meta-analytic approach.4-7 As discussed in the introduction to this series,5 R/S encompasses a diverse set of beliefs, feelings, and practices. As a result, these meta-analyses were aimed at identifying the degree of association between measures of R/S and patient-reported health outcomes in 3 separate areas (mental, physical, and social) and, furthermore, at comparing the strengths of different R/S dimensions (cognitive, affective, behavioral, and ‘other’) within each of those health domains. The analyses sought evidence of both positive and negative effects. In this final article, we summarize the findings across these 3 different health domains and compare and contrast the results. We then discuss caveats in interpreting this set of analyses, provide directions for future research, and make tentative suggestions for clinical applications.