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Assessing the impact of religious resources and struggle on well-being: a report from the American Cancer Society’s Study of Cancer Survivors-I

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Abstract

Purpose

The current study examined the relationships between religious resources (i.e., certainty of belief in God and attendance at religious services), religious struggle (e.g., belief that cancer is evidence of God’s punishment or abandonment), and physical and mental health-related quality of life (HRQoL), including fear of cancer recurrence (FCR), in a large, geographically and clinically diverse sample of long-term survivors of cancer.

Methods

Participants were 2021 9-year survivors of cancer from the American Cancer Society’s Study of Cancer Survivors – I. Religious resources included belief in God and attendance at religious services. Items from the Brief RCOPE and the PROMIS Psychosocial Impact of Illness were combined to assess religious struggle. Survivors also completed the Fear of Cancer Recurrence Inventory, SF-12, and Meaning and Peace subscales of the FACIT-Sp. Regression models were used to predict HRQoL and FCR from religious resources and struggle.

Results

In multivariable models, certain belief in God predicted greater mental HRQoL (B = 1.99, p < .01), and attendance at religious services was associated with greater FCR (B = .80, p < .05) as well as better mental (B = .34, p < .01) and physical (B = .29, p < .05) HRQoL. In addition, religious struggle predicted greater FCR (B = 1.32, p < .001) and poorer mental (B =  − .59, p < .001) and physical (B =  − .29, p < .001) HRQoL. Many of these relationships were mediated through Meaning.

Conclusions

With the exception of FCR, religious resources predicted better HRQoL outcomes in these long-term survivors of cancer. Conversely, religious struggle consistently predicted poorer HRQoL, including greater FCR.

Implications for Cancer Survivors

Given the documented importance of its role in coping with the cancer experience, religion/spirituality should be a consideration in every survivorship care plan. Multidisciplinary assessment and support of religious resources and identification of and referral for religious struggle are needed to ensure the well-being of most long-term survivors of cancer.

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Data availability

The data that support the findings of this study are available from the co-authors at the American Cancer Society upon reasonable request and Society approval.

Code availability

Not applicable.

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Acknowledgements

We are grateful for the assistance of Kristen Schenk in the preparation of the manuscript. The authors assume full responsibility for analyses and interpretation of the data collected from these data. Certain data used in this study were obtained from the Connecticut Tumor Registry located in the Connecticut Department of Public Health. Name, phone number, address, doctor name, social security number, date of birth, date of diagnosis, gender, cancer type, primary site, race, Hispanic origin, and stage and grade at diagnosis study were obtained from the Connecticut Tumor Registry located in the Connecticut Department of Public Health. The authors thank all the study participants; the physicians of the participants; Susan Higgins, MD; Project Director Annie O’Neill; Rajni Mehta, Director of the Rapid Case Ascertainment Shared Resource of the Yale Cancer Center and the following Connecticut Hospitals: Charlotte Hungerford Hospital, Bridgeport Hospital, Danbury Hospital, Hartford Hospital, Middlesex Hospital, New Britain General Hospital, Bradley Memorial Hospital, Yale/New Haven Hospital, St. Francis Hospital and Medical Center, St. Mary’s Hospital, Hospital of St. Raphael, St. Vincent’s Medical Center, Stamford Hospital, William W. Backus Hospital, Windham Hospital, Eastern Connecticut Health Network, Griffin Hospital, Bristol Hospital, Johnson Memorial Hospital, Day Kimball Hospital, Greenwich Hospital, Lawrence and Memorial Hospital, Milford Hospital, New Milford Hospital, Norwalk Hospital, Sharon Hospital, and Waterbury Hospital.

Funding

The American Cancer Society (ACS) Studies of Cancer Survivors were funded as an intramural program of research conducted by the ACS Behavioral Research Center.

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Authors and Affiliations

  1. Rosemead School of Psychology, Biola University, 13800 Biola Ave, La Mirada, CA, 90639, USA

    Andrea L. Canada

  2. Religion, Health, and Human Values, Rush University Medical Center, Chicago, USA

    Patricia E. Murphy & George Fitchett

  3. Rollins School of Public Health, Emory University, Atlanta, USA

    Kevin Stein

  4. Oncology, Johns Hopkins University School of Medicine, Baltimore, USA

    Kassandra I. Alcaraz

  5. Population Science, American Cancer Society, Atlanta, USA

    Corinne R. Leach

Authors
  1. Andrea L. Canada
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  2. Patricia E. Murphy
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  4. Kassandra I. Alcaraz
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  5. Corinne R. Leach
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  6. George Fitchett
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Contributions

Andrea Canada: conceptualization, analysis, interpretation, writing—original draft. Patricia Murphy: conceptualization, analysis, interpretation, writing—review and editing. Kevin Stein: funding acquisition, data curation, conceptualization, writing—review and editing. Kassandra Alcaraz: conceptualization, writing—review and editing. Corinne Leach: conceptualization, writing—review and editing. George Fitchett: conceptualization, interpretation, writing—review and editing.

Corresponding author

Correspondence to Andrea L. Canada.

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The Emory University Institutional Review Board approved SCS-I (IRB00001853) and additional approvals were obtained for each state, including the Connecticut Department of Public Health Human Investigation Committee.

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The authors declare no competing interests.

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Canada, A.L., Murphy, P.E., Stein, K. et al. Assessing the impact of religious resources and struggle on well-being: a report from the American Cancer Society’s Study of Cancer Survivors-I. J Cancer Surviv 17, 360–369 (2023). https://doi.org/10.1007/s11764-022-01226-8

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