Relationship Between Religion/Spirituality and the Aggressiveness of Cancer Care: A Scoping Review

Context. Religiosity/spirituality/religious-spiritual coping (RS) are resources used by cancer patients with cancer to help cope with the disease and may influence the preference and receipt of end-of-life (EOL) treatment.Objectives. To examine the relationship between RS and the EOL care preferred or received by cancer patients.Methods. This review protocol is registered on (International Prospective Register of Systematic Review, CRD42021251833) and follows the recommendations of the preferred reporting items for systematic reviews and meta -analy-ses checklist. Embase, Proquest, PubMed, Scopus, and Web of Science databases were consulted. Google Scholar was con-sulted for additional publications and gray literature. Quantitative studies including adults with any cancer type/stage were eligible. The paper selection was performed by two independent reviewers; the methodological quality was measured using the Newcastle Ottawa scale.Results. Seventeen studies were included in the review. In general, RS is related to the preference or receipt of aggressive EOL care and with less advance care planning. Spiritual care by the medical team is related to higher referral to hospice and less aggressive care; in contrast, high spiritual support from religious communities is associated with less hospice and more aggressive care. Religious denominations influenced health care preferences, as Catholics were less likely to sign a do-not -resus-citate order and Buddhists or Taoists received more aggressive interventions at the EOL. Most studies (70%) were of high qual-ity according to the Newcastle Ottawa scale.Conclusion. RS is associated with more aggressive EOL treatments, as well as with lower rates of ACP in cancer patients. On the other hand, spiritual care provided by the medical team seems to be associated with less aggressive EOL care. J Pain Symp-tom Manage 2023;65:e425-e437.(c) 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.