Psychosocial correlates of cancer relapse and survival: a literature review

This article reviews literature on the psychosocial correlates of cancer re lapse and survival from 1979 through 1995. The factors studied were structu red according to a theoretical model of coping with cancer. Reviewed studie s have shown that factors most frequently evaluated were depression, anxiet y, hopelessness/helplessness, hostility, marital status and social involvem ent. Mainly inconsistent: results were found. The strongest evidence for a relationship between psychosocial variables and prognosis was found for soc ial involvement/social support; in 7 of 15 studies a positive relationship was demonstrated, while no negative associations were found. Coping styles e.g., fighting spirit and stoic acceptance, and severe/stressful life event s were found to have no conclusive influence on the length of survival. Imp ortant determinants of the coping model, such as uncertainty and informatio n given by the specialist were not studied as possible predictors of surviv al and/or relapse free period. Among the factors that showed no correlation at all was multidimensional health locus of control. For the inconsistent findings, a considerable number of methodologic shortcomings with respect t o study design, sample size, measure and statistical analysis are enumerate d. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.