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For whom and what outcomes does cognitive-behavioral-therapy work among cancer survivors: a systematic review and
Anao Zhang1,2, Kaipeng Wang3, Kate Blumenstein4
1University of Michigan School of Social Work, 1080 South University Avenue, MI, 48109, Ann Arbor, USA. zhangan@med.umich.edu.
Objective:
To perform a systematic review and meta-analysis of CBT for individuals diagnosed with cancer across a broad range of outcome domains, i.e., functional health, psychological health, health behaviors, social relational, and general wellness.
Methods:
A comprehensive search of 7 databases, 91 published reviews, and 4 professional websites was performed on August 30th, 2021. English-language clinical trials of CBT for cancer patients/survivors were included. Studies were independently screened, and data were extracted by 2 reviewers, and discrepancies were resolved by consensus among the investigative team. A total of 151 clinical trials (154 articles) published between 1986 and 2021 were included in the analysis.
Results:
CBT was overall effective for cancer patients/survivors in the domains of functional health, g = 0.931, p < 0.001, psychological health, g = 0.379, p < 0.001, and general wellness, g = 0.257, p < 0.001, but ineffective in domains of health behaviors, g = 0.792, p > 0.05, and social relational outcomes, g = 0.319, p > 0.05. Additional subgroup and moderator analyses further revealed CBT's differential treatment effect for different within domain outcomes, across different cancer disease stages, and CBT delivery format.
Conclusions:
Findings of the study showed that CBT is an effective treatment for individuals diagnosed with cancer. However, treatment effects differ by important disease- and intervention-related factors, which should be considered when recommending CBT for cancer patients/survivors.
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