The role of religion and spirituality in cancer care: An umbrella review of the literature

Although some studies have suggested a strong relationship between religion and spirituality (R & S) and patient outcomes in cancer care, other data have been mixed or even noted adverse effects associated with R & S in the healthcare setting. We sought to perform an umbrella review to systematically appraise and synthesize the current body of literature on the role of patient R & S in cancer care. A systematic search of the literature was conducted that focused on "cancer " (neoplasm, malignant neoplasm, malignancy), "spirituality " (beliefs, divine), and "religion " (specific practices like Christianity, faith, faith healing, prayer, Theology). A total of 41 review articles published from 1995 to 2019 were included: 8 systematic reviews, 6 meta-analyses, 4 systematic reviews and meta-analysis, and 23 other general reviews. The number of studies included in each review ranged from 7 to 148, while 10 studies did not indicate sample size. Most articles did not focus on a specific cancer diagnosis (n = 36), stage of cancer (n = 32), or patient population (n = 34). Many articles noted that R & S had a positive impact on cancer care, yet some reviews reported inconclusive or negative results. Marked variation in methodological approaches to studying R & S among cancer patients, including operational definitions and measurement, were identified. Resolving these issues will be an important step to understanding how patients seek to have R & S integrated into their patient-centered cancer care experience.